胆总管囊状扩张超声分型及其临床意义

CLASSIFYING CYSTIC DILATATION OF COMMON BILE DUCT WITH ULTRASOUND AND IT'S CLINICAL SIGNIFICANCE

目的 对胆总管囊状扩张的声像图进行分类 ,并对各类型声像诊断特点及其临床意义进行探讨。方法 对 65例胆总管囊状扩张患者超声检查的声像表现及其它临床资料进行总结分析。结果 胆总管囊状扩张患者 65例 ,男 18例 ,女 4 7例 ,平均年龄 8.9岁。根据胆总管囊状扩张的声像特点将其声像分为 5种类型 :A型 :胆总管呈梭形扩张 ,2 1例 ,占 3 2 .3 % ;B型 :胆总管呈球形扩张 ,16例 ,占 2 4 .6% ;C型 :胆总管扩张显著 ,表现为右上腹部的囊性肿物 ,2 2例 ,占 3 3 .8% ;D型 :胆总管重度扩张 ,表现为腹部巨大囊性肿物 ,6例 ,占 9.2 % ;E型 :胆总管囊状扩张合并肝内胆管囊状扩张 ,10例 ,占 15 .4 %。结论 超声检查是诊断胆总管囊状扩张的首选影像学方法。 A型和 B型是胆总管囊性扩张程度较轻的二种情况 ,在这二型的病例 ,声像图中可以清晰地显示肝外胆管结构 ,故较容易做出诊断。 C型和 D型是胆总管扩张程度较重的类型 ,表现为腹部囊性肿物 ,超声诊断有一定难度 ,需要与其它病变进行鉴别。 E型扩张的肝内、外胆管常延续相通 ,超声容易明确诊断。

Objective To classify the cystic dilatation of the common bile duct for reseaching the diagnostic characteristic of each type and the clinical significance.Methods Summarizing and analyzing the datas of ultrasound and clinical from patients with cystic dilatation of common bile duct.Results There are 65 cases with the disease (18 males,47 females) whose average age is 8.9 year.The sonograms have been classifiecl to 5 types:A type,choledochus is fusiform dilatation with 21 cases (32.3%);B type,choledochus is globular dilatation with 16 cases (24.6%);C type,choledochus is notable dilatation and sonogram is a right epigastric cyst with 22 cases (33.8%);D type,choledochus is serious dilatation and sonogram is a enomous abdomen cyst with 6 cases (9.2%);E type,choledochus cystic dilatation combine with intrahepatic bile duct cystic dilatation with 10 cases (15.4%).Conclusion Ultrasound is the first selection for the diagnosing.A and B types are ligher degrees of the disease,and structure of extrahepatic bile duct can be showed clearly in sonogram,and diagnosis is easy.C and D types are serious degrees of the disease and shows abdomen cyst in sonogram,and there are some difficulty for diagnosis and differentiation.In E type,extrahepatic and intrahepatic dilatable bile duct are continue and communication and diagnosis is easy.