实时超声技术在胆管癌诊断和腔内放疗中的应用

Application of Ultrasonography to Diagnosis and Brachytherapy of Cholangiocarcinoma

目的 探讨超声技术在胆管癌诊断和腔内治疗定位、复查的价值。方法 32例超声诊断胆管癌 ,经手术和病理证实 ,超声诊断准确率达 84.4%,对 7例不能手术切除的肝门部胆管癌术中放置U型引流管 ,术后 1～ 2周U型管内行后装192 Ir腔内照射 ,照射剂量平均 6 0 0～ 80 0cGy ,总量 2 4～ 80Gy。 结果 超声诊断率 84.4%,手术无法切除的肝门部胆管癌腔内照射后生存期延长 ,平均 10 .6个月。结论 超声可使胆管癌诊断率提高 ,经B超定位置U型管腔内放疗 ,使平均生存期延长 2～ 3倍。

Objective Ultrasonography applied to diagnosis and treatment with +{192}Ir intraluminal radiation of cholangiocarcinoma was evaluated. Methods Thirty-two ultrasonic-diagnosed cases of cholangiocarcinoma were confirmed by surgery and pathology. The ultrasonic diagnostic accuracy was 84.4%. Between one week and two weeks after operation, intraluminal radiotherapy was performed by +{192}Ir afterloading treatment system through a U-tube placed during surgery in seven patients with cholangiocarcinoma in liver port which could not be resected. Single intraluminal radiation dose averages 600～800cGy. Total radiation dose adds up to 24～80Gy. Results Ultrasonic diagnostic accuracy of cholangiocarcinoma was 84.4%. The average life span of those patients with cholangiocarcinoma in liver port which could not be resected by surgery was increased to 10.6 months after +{192}Ir intraluminal radiotherapy. Conclusion Ultrasonography can improve the diagnostic accuracy of cholangiocarcinoma. +{192}Ir intraluminal radiotherapy with B-mode ultrasonic location may increase the average life span of patients with cholangiocarcinoma by 2～3 times.