高频超声造影对胆囊内蛔虫残骸的诊断价值

Diagnostic value of high-frequency contrast-enhanced ultrasound in the ascaris debris in the gallbladder

目的:探讨超声造影技术(contrast-enhanced ultrasound,CEUS)联合高频线阵超声探头对胆囊内蛔虫残骸和肿瘤性病变的鉴别诊断价值。方法:回顾性分析2015年6月至2018年6月复旦大学附属中山医院收治的9例胆囊内蛔虫残骸患者和20例经手术证实胆囊内肿瘤患者的超声造影表现。根据EFSUMB超声造影指南,鉴别比较2组患者常规超声和高频超声造影表现。结果:胆囊内蛔虫残骸与胆囊低回声肿瘤在二维超声上,都表现为低回声不均质实质占位。但所有胆囊内蛔虫残骸在高频超声造影各个时期都未见明显增强,而胆囊肿瘤都表现为一定程度的增强-消退改变。结论:高频超声造影凭借实时显像、安全简便等优势,可敏感、准确地鉴别胆囊内蛔虫残骸和胆囊内实质性肿瘤。

Objective:To explore the value of contrast-enhanced ultrasound(CEUS)combined with high-frequency linear ultrasound probe for the differential diagnosis of ascaris debris and neoplasm of the gallbladder.Methods:The contrast-enhanced ultrasound findings of 9 patients with ascaris debris and 20 patients with neoplasia of the gallbladder confirmed by surgery in Zhongshan Hospital,Fudan University from June 2015 to June 2018 were retrospectively analyzed.Results of the conventional B-mode ultrasound(BMUS)and CEUS enhancement pattern of the lesions were compared and analyzed according to the current EFSUMB guidelines.Results:The ascaris debris in the gallbladder and the hypoechoic tumor of the gallbladder were both characterized by hypoechoic heterogeneous solid occupation on BMUS.The signals of all pieces of ascaris debris in the gallbladder were not significantly enhanced during each phase of CEUS.However,gallbladder tumors present with some degree of enhancement-regression changes at each phase of CEUS.Conclusion:Depending on the advantages of being real-time,safe and simple,CEUS can sensitively and accurately distinguish the ascaris debris and solid neoplasm in the gallbladder.