超声造影和常规超声在诊断胆囊腺肌症中的应用价值

The value of contrast-enhanced ultrasound and conventional ultrasound in the diagnosis of gallbladder adenomyomatosis

目的:探讨胆囊腺肌症(Gallbladder adenomyomatosis,GA)应用超声造影和常规超声诊断的临床价值。方法:临床纳入我院2012年1月至2015年1月收治的胆囊腺肌症患者28例,均经病理诊断确诊,分别予以常规超声和超声造影检查,并对比分析两种检查后的图像特征,总结两种检查诊断胆囊腺肌症的准确率情况。结果:胆囊腺肌症常规超声检查显示所有患者图像均表现出胆囊壁增厚(局部)征象,病灶界限:0.7mm×0.4mm×2.6mm×1.3mm。典型表现为胆囊壁呈扁平状增厚(局部),内部可见散在的微小无回声,个别伴强回声、后方"彗星尾"征;以此依据诊断的准确率是67.9%(19/28)。超声造影声像图典型表现为动脉相和静脉相均呈现出不均匀增强,内部可见散在性细小无增强区域;以此依据诊断的准确率96.4%(27/28)。超声造影诊断的准确率高于常规超声(χ2=7.79,P<0.05)。结论:胆囊腺肌症采用常规超声和超声造影诊断,图像表现各具特征性,其中超声造影有效提高临床诊断的准确性,具有推广价值。

Objective：To investigate the clinical value of contrast-enhanced ultrasonography and conventional ultrasound in the diagnosis of gallbladder adenomyomatosis（GA）.Methods：The clinical in 28 patients with gallbladder adenomyomatosis in our hospital from January 2012 to January 2015 were included,all were diagnosed by pathology,were treated by conventional ultrasound and contrast-enhanced ultrasound respectively,and compared the image characteristics of two kinds of examination,summed up the two kinds of diagnosis of adenomyomatosis of the accurate rate.Results：Conventional ultrasound examination showed that all patients with gallbladder adenomyomatosis showed gallbladder wall thickening（local） signs,the lesion boundaries：0.7mm ＊ 0.4mm ＊ 2.6mm ＊ 1.3mm.The typical manifestation of the gallbladder wall was a flat thickening（local）,scattered within the small echo,the individual with strong echo,the rear ＂comet tail＂ sign;according to the diagnostic accuracy rate was 67.9%（19/28）.Contrast enhanced ultrasound showed that the arterial and venous phases showed inhomogeneous enhancement,and there was a small and no enhancement in the interior;The diagnostic accuracy rate was 96.4%（27/28）.The accuracy of contrast-enhanced ultrasound was significantly higher than that of conventional ultrasound（X2=7.79,P〈0.05）.Conclusion：The use of conventional ultrasound and contrast-enhanced ultrasound in the diagnosis of gallbladder adenomyomatosis,the image has its own characteristics,which can effectively improve the accuracy of clinical diagnosis,and has the value of promotion.