彩色多普勒超声在胆囊腺瘤与胆囊癌鉴别诊断中的临床价值

Value of color Doppler ultrasonography in differential diagnosis of gallbladder carcinoma and gallbladder adenoma

目的探讨彩色多普勒超声在胆囊腺瘤与胆囊癌鉴别诊断中的临床价值。方法选取我院2013年1月至2016年12月经病理证实为胆囊腺瘤(95例)和胆囊癌(100例)的患者进行临床研究,所有患者均经彩色多普勒超声诊断,分析比较胆囊腺瘤与胆囊癌各项指标的差异。结果 95例胆囊腺瘤患者中合并胆囊腔内结石18例(18.95%),合并壁内结石13例(13.68%);胆囊浆膜层均显示完整(95/95);CDFI在胆囊腺瘤增厚囊壁内未测及明显血流信号共89例(93.68%),仅6例测及少量星点状血流信号。100例胆囊癌患者中合并腔内结石20例(20.00%),无1例合并壁内结石,胆囊浆膜层显示不完整57例(57.00%),CDFI在胆囊癌肿块内测及丰富血流信号者共82例(82.00%),形态呈"网篮样"改变;胆囊癌体积、最大血流速度均大于胆囊腺瘤,差异具有统计学意义(P<0.001)。结论彩色多普勒超声对胆囊腺瘤与胆囊癌具有较高的鉴别诊断价值。

Objective Toinvestigate the valueof color Doppler ultrasonography in differential diagnosis of gallbladder adenoma and gallbladder carcinoma. Methods A total of 195 patients with gallbladder tumor in our hospital between January 2013 and December 2016 were enrolled. All patients underwent the examinations by color Doppler ultrasound. They were divided into gallbladder adenoma group （95 cases） and gallbladder carcinoma group （100 cases） according to pathological confirmation. Imaging features and other parameters were analyzed between two groups. Results Among the 95 cases of gallbladder adenoma, 18 cases （18.95%） were combined with cholelithiasis and 13 cases （13.68%） were found with intramural gallstones. The serosa of gallbladder showed intact in all adenoma cases （95/95）. Color Doppler flow imaging （ CDFI） signal was not ob-viously observed in the thickened gallbladder adenomatous walls in 89 cases （93.68%） and punctiform CDFI signals were observed in only 6 cases. Among the 100 cases of gallbladder carcinoma, 20 cases （20.00%） were combined with cholelithiasis. No case was found intramural gallstones. The serosa of gallbladder showed in-complete in 57 cases （57.00%）. CDFI was found abundant signals with basket pattern in 82 cases o f gallbladder cancer （82.00%; P 〈 0.001）. The measured tumor size and the maximum blood flow velocity in gallbladder carcinoma were significantly higher than those in gallbladderadenoma （P 〈 0.001）. Conclusion Color Doppler ultrasonography is of high value in differential diagnosis between gallbladder adenoma and gallbladder carcinoma