不同肝胆疾病患者胆囊CT表现分析

Comparison of gallbladder CT manifestations between patients with chronic cholecystitis and with chronic liver diseases

目的分析比较慢性胆囊炎与慢性肝病患者胆囊CT表现的差异。方法 2014年11月～2017年10月我科诊治的慢性肝病患者52例(慢性乙型肝炎21例,乙型肝炎肝硬化26例,原发性肝癌5例)和慢性胆囊疾病患者32例(慢性胆囊炎20例,急性化脓性胆囊炎7例,急性胰腺炎合并胆囊炎3例,黄色肉芽肿性胆囊炎1例,坏疽性胆囊炎1例),接受多排螺旋CT增强检查。结果慢性胆囊疾病患者囊壁厚径显著大于慢性肝病患者[(4.5±0.5)mm对(3.7±0.4)mm,P<0.05],囊壁强化、胆汁密度增高、邻近肝组织一过性强化显著多于慢性肝病组100.0%对75.0%、31.3%对5.8%和18.8%对0.0%,而胆囊周围粘连和胆囊周围积液发生率显著低于慢性肝病组[9.4%对75.0%和9.4%对28.9%,P<0.05]。结论胆囊炎和肝病性胆囊改变的CT表现存在差异,主要表现在胆囊改变、胆汁密度上升、胆囊周围积液等方面。

Objective To compare the features of gallbladder CT manifestations between patients with chronic cholecystitis and with chronic liver diseases. Methods 52 patients with chronic liver diseases (chronic hepatitis B in 21,hepatitis B cirrhosis in 26 and primary liver caner in 5) and 32 patients with chronic cholecystitis were checked-up in our Department of Radiology beween November 2014 and October 2017. We analyzed their gallbladder CT manifestations. Results The gallbladder wall thickness in patients with chronic cholecystitis was significantly thicker than in patients with chronic liver disease [(4.5±0.5) mm vs.(3.7±0.4) mm,P<0.05],the incidences of cystic wall enhancement,increased bile density and transient enhancement of adjacent liver tissues were much higher than in patients with chronic liver diseases(100.0% vs. 75.0%,31.3% vs. 5.8% and 18.8% vs. 0.0%),while the incidences of adhesion to peripheral tissues and gallbladder effusion were significantly lower than in patients with chronic liver diseases (9.4% vs. 75.0% and 9.4% vs. 28.9%,P<0.05). Conclusion The CT manifestations of gallbladder in patients with chronic cholecystitis and liver disease are different,which might be helpful for clinicians to differentiate them.