超声造影在肝外胆管癌诊断中的应用

Application of CEUS in diagnosis of extrahepatic cholangiocarcinoma

目的采用CEUS观察肝外胆管癌(ECC)的灌注过程及增强特点。方法收集经病理证实的55例ECC患者。先行常规超声检查,再启动实时CEUS成像技术模式,评估分析病灶的增强方式、始增时间,并与常规超声比较诊断准确率。结果 CEUS的诊断准确率(52/55,94.55%)高于常规超声(44/55,80.00%;χ2=5.24,P<0.05)。不同类型病灶造影增强方式构成比差异有统计学意义(P<0.001),94.12%(16/17)厚壁型病灶为均匀增强,63.16%(12/19)团块型病灶为周边环形增强。不同类型病灶的始增时间构成比差异有统计学意义(P<0.001),94.12%(16/17)厚壁型病灶始增时间晚于肝脏/胆管壁始增时间,63.16%(12/19)团块型病灶始增时间早于肝脏/胆管壁始增时间。结论采用CEUS可以提高ECC的诊断准确率,不同类型ECC的始增时间和增强方式有其特征性,值得临床推广及应用。

Objective To evaluate the contrast perfusion and enhancement patterns of extrahepatic cholangiocarcinoma （ECC） with CEUS. Methods Totally 55 ECC patients confirmed by pathology were enrolled. All patients underwent con- ventional ultrasound firstly, then CEUS was performed. The diagnostic accuracy of CEUS was compared with conventional ultrasound. Results The diagnostic accuracy of CEUS （52/55, 94.55%） was higher than that of conventional ultrasound （44/55, 80.00% ; Z2 =5.24, P〈0.05）. The enhancement mode differed in tumor types （P〈0. 001）, 94. 12% （16/17） of the thick-wall masses were homogeneously enhanced, while 63.16% （12/19） of the block-shaped masses got rim-like en7 hancement. The contrast arrive time differed in tumor types （P〈0. 001）, 94.12% （16/19） of the thick-wall masses en- hanced later than the normal liver/bile duct wall; while 63.16% （12/19） of the block-shaped masses enhanced earlier than the normal liver/bile duet wall. Conclusion Different tumor types have certain characteristics of enhancement mode and contrast arrive time. CEUS can improve the diagnostic accuracy of ECC and deserve clinical promotion.