黄色肉芽肿性胆囊炎超声造影影像学特征分析

Contrast-enhanced ultrasonography of xanthogranulomatous cholecystitis

目的:探讨黄色肉芽肿性胆囊炎(xanthogranulomatous cholecystitis,XGC)的超声造影声像图特征。方法:收集2015年1月至2019年12月于复旦大学附属中山医院术后病理证实为XGC的24例患者术前的临床资料及超声声像图,分析其常规超声以及超声造影的声像图特征,并在造影前后分别给出超声诊断。结果:常规超声示胆囊轮廓清晰17例(70.8%),模糊7例(29.2%),仅2例(8.3%)胆囊黏膜线连续性佳,17例(70.8%)病灶内可测及彩色血流。超声造影后所有病例(100.0%)均可见增强,同时可见清晰的胆囊轮廓,黏膜线连续性佳者18例(75.0%)。超声造影与常规超声相比,在胆囊黏膜线的显示、胆囊轮廓的显示以及增厚胆囊壁血流检出率,差异均有统计学意义(P<0.001,P=0.009,P=0.009)。结论:超声造影可为XGC的超声诊断提供更多的信息,相比于常规超声其诊断效能更高。

Objective:To explore the characteristics of contrast-enhanced ultrasonography(CEUS)in xanthogranulomatous cholecystitis(XGC).Methods:The clinical data of 24 patients with postoperative pathological diagnosis of XGC in the past 5 years were collected.The sonographic characteristics of conventional ultrasound and CEUS results were analyzed.Results:Conventional ultrasound results showed that the contour of gallbladder was clear in 17 cases(70.8%),fuzzy in 7 cases(29.2%),and the continuity of gallbladder mucosa was good in only 2 cases(8.3%),rich color flow signal could be detected in 17 cases(70.8%).On CEUS,enhancement could be detected in all cases(100.0%),all cases showed clear gallbladder contour(100.0%),and the continuity of mucosal line was good in 18 cases(75.0%).Compared with conventional ultrasound,CEUS had significant difference in the display of gallbladder mucosal line,gallbladder contour,and the detection rate of thickened gallbladder wall blood flow(P<0.001,P=0.009 and P=0.009).Conclusions:CEUS might provide more diagnostic information for XGC,and be more helpful in the diagnosis of XGC than conventional ultrasound.