十二指肠乳头区肿瘤71例超声诊断价值

The evaluation of ultrasound in diagnosisi 71 cases tumors of duodenal papilla

目的 总结十二指肠乳头区肿瘤的超声特点,探讨超声对十二指肠乳头区肿瘤的诊断价值。方法 回顾性分析了1991-2001年经手术和病理证实的71例十二指肠乳头区肿瘤。结果 术前超声诊断为十二指肠乳头肿瘤51例(71.8％),误诊胰头癌4例,误诊胆管末端癌5例,误诊为胆总管结石2例,误诊为壶腹部结石1例,诊断胃扩张2例,提示胰胆管扩张,胆囊增大6例。超声在十二指肠乳头区肿瘤定位诊断中的准确性与检查者的手法及经验密切相关,本组超声定位准确率88.7％,高于CT(84％),低于ERCP(96％)。超声为目前诊断十二指肠乳头区肿瘤首选的最佳方法。结论 超声和ERCP联合检查可提高十二指肠乳头区肿瘤检出率。

Objective To study the characteristic of ultrasound and diagnositcal evaluation of ultrasound in the tumor of duodenal papilla. Methods Severty - one cases of tumors of duodenal papilla were studied retrospective Those tumors were diagnosed by operations and pathologies. Results Before operational cases (71.8%) were correct diagnosis with ultrasound,20 cases were mis diagnosis with ultrasound. Four cases were carcinoma of head of pancreas, Five cases were cancer of ternmjnal common bile duct, Two cases were stone of comman bile duct. One case was stone of ampullar region. Two cases were stomach expansion. Sonographies of 6 cases were pancreatic duct and bile duct dilated, and gallbladder enlarged. The accurate diagnosis of ultrasound was related to technique and experiment of operator. The accurate rate of sonographical location was 88. 7% . The result compared with CT and ERCP was higher than CT(84% ), lower than ERCP(96% ) , Sonography was first selected diagnostic method in tumor of duodenum. Conclustion Combine ultrasound and ERCP would increased the positive rate of tumor of duodenal papilla.