经静脉联合经胆道超声造影在肝门部胆管癌分型诊断中的价值

The value of intra-venous combined with intra-cavitary contrast-enhanced ultrasound in the classification of hilar cholangiocarcinoma

目的探讨经静脉联合经胆道超声造影在肝门部胆管癌分型诊断中的价值。方法回顾分析30例经增强CT或增强MRI诊断为肝门部胆管癌患者的常规超声、经静脉超声造影与经胆道超声造影表现，比较常规超声、经静脉超声造影、经胆道超声造影、经静脉联合经胆道超声造影对肝门部胆管癌的分型诊断准确率。结果30例患者中，常规超声、经静脉超声造影、经胆道超声造影、经静脉联合经胆道超声造影的分型诊断准确率分别为73．3％（22／30）、90．0％（27／30）、86．7％（26／30）及96．7％（29／30）。其中，经静脉联合经胆道超声造影的分型准确率优于常规超声（P=0．011），经静脉超声造影或经胆道超声造影单独与常规超声比较差异无统计学意义（P=0．095和0．197）。结论经静脉联合经胆道超声造影能够全面评估肝门部胆管癌胆管腔内腔外病变情况，提高超声对肝门部胆管癌分型诊断的准确率。

Objective To explore the value of intra-venous contrast-enhanced ultrasound （IV CEUS） combined with intra-cavitary CEUS （IC-CEUS） in the classification of hilar cholangiocarcinoma. Methods Thirty patients who were diagnosed as hilar cholangiocarcinomas by contrast-enhanced computed tomography and contrast-enhanced computed magnetic resonance imaging were enrolled in this study. All of them underwent conventional ultrasound, IV-CEUS and IC-CEUS. According to Bismuth-Corlette classification, the accuracies of classification were compared among conventional ultrasound, IV-CEUS, IC- CEUS and IV-CEUS combined with IC-CEUS. Results The classification accuracies of conventional ultrasound,IV-CEUS,IC-CEUS and IV-CEUS combined with IC-CEUS were 73.3%（22/30）,90.0% （27/ 30） ,86.7% （26/30） and 96.7%（29/30） ,respectively. IV-CEUS combined with IC-CEUS was superior to conventional ultrasound （P = 0. 011）. There were no significant differences when conventional ultrasound compared with IV-CEUS or IC-CEUS alone （ P = 0. 095 and 0. 197）. Conclusions IV-CEUS combined with IC-CEUS can evaluate the intra-biliary and extra-biliary changes of hilar cholangiocarcinoma roundly. The classification accuracy of hilar cholangiocarcinom will be improved using IV-CEUS combined with IC- CEUS.