彩色多普勒血流显像对原发性胆囊癌的诊断意义

Significance of color Dopoler flow imaging in the diagnosis of primary gallbladder cancer

目的 观察胆囊壁或胆囊内肿物的异常高速血流信号 ,探讨彩色多普勒血流显像对原发性胆囊癌的诊断意义。方法 以彩色多普勒血流显像对 2 2例原发性胆囊癌患者和 3 0名正常人的胆囊动脉进行检测。所用指标为 :最大流速 (Vmax)、最低流速 (Vmin)、平均流速 (Vmean)、搏动指数 (PI)、阻力指数 (RI)和最大流速与最低流速之比 (A/B值 )。结果 2 2例原发性胆囊癌患者中 17例测到胆囊动脉血流频谱 ,与正常组比较 ,Vmax、Vmin、Vmean均明显增快 (P <0 .0 0 1) ,RI、PI和A/B值二组间无显著性差异 (P >0 .1)。 16例以实质性肿物为表现的原发性胆囊癌的肿块内测到高阻中速血流频谱。结论 胆囊动脉的高阻高、中速血流信号 ,是原发性胆囊癌具有诊断价值的特征。肿瘤内的血流信号是鉴别胆囊癌与由结石和胆泥所形成的伪瘤样回声的可靠征象。

Objective To obeserve the abnormal high velocity arterial blood flow signal within masses of the gallbladder and gallbladder wall,in order to investigae the significances of the color Doppler flow imaging in diagnosing the primary gallbladder cancer.Methods Data of the gallbladder artery of 22 cases with primary gallbladder adenocarcinoma and 30 normal persons were measured by color Doppler flow imaging.The measured indexes included the maximum blood flow velocity (V max ),minimum blood flow velocity (V min ),time average blood flow velocity (V mean ),pulsatility index(PI),resistance index (RI),and ratio of the maximum to minimum blood flow velocity (A/B).Results Blood flow signals were measured in 17 of 22 cases with primary gallbladder cancer.Their V max ,V min and V mean were significantly higher than those in normal control group (P< 0.001 ).But RI,PI and A/B ratio had no significant difference between gallbladder cancer group and normal control group.Sixteen of 22 cases with primary gallbladder cancer showed a high resistance and medium velocity blood flow signal within solid masses.Conclusions High velocity blood flow of gallbladder artery is a valuable characteristic for diagnosing the primary gallbladder cancer.Blood flow signal within masses are a reliable sign for distinguishing tumor echo from tumorlike echo which is formed by stone and sludge.