超声诊断胆囊结石的应用及影像学特征

Application and Imaging Features of Ultrasonography in the Diagnosis of Gallstone

目的:分析对胆囊结石患者实施超声诊断及影像学特征。方法:从2018年1月至2020年1月择取120例疑似胆囊结石患者,所选患者均实施超声诊断,并对照手术病理诊断结果,分析超声诊断结果及影像学特征。结果:从诊断结果来看,手术病理诊断中118例患者确诊为胆囊结石,确诊率为98.33%(118/120),其中典型胆囊结石63例、充满型胆囊结石34例、胆囊颈结石13例、泥沙样型结石8例,超声诊断中114例患者确诊为胆囊结石,其中典型胆囊结石61例、充满型胆囊结石33例、胆囊颈结石12例、泥沙样型结石8例,诊断符合率为96.61%(114/118)。从超声影像学特征来看,典型胆囊结石可见胆壁粗糙,而且毛糙度高,腔内形态稳定,边界清晰,有强回声团,检查期间若移动体位,则后方声影、回声团随之改变。充满型胆囊结石可见胆囊壁增厚,大部分病例胆囊内无明显液性透声腔,胆囊后半部分以及后壁未完全显示,囊壁、结石、声影三合征(即WES症)清晰。胆囊颈结石可见在胆汁衬托下横切面上部分胆囊颈、结石嵌顿明显,结石具体位置无法确定,胆囊肿大,需要改变体位为左前倾位,以更好地暴露结石。泥沙样型结石中,结石大小差异,胆囊结石特征不同,沉积厚、颗粒大的结石声影有移动性,且有沉积状强回声带,颗粒小的结石胆囊后壁粗糙,毛糙感高,相比于前壁、侧壁,后壁回声更强,回声随体位变化出现细小发丝状强回声。结论:对胆囊结石患者实施超声诊断可以对具体疾病状况进行明确,医学影像清晰,临床价值显著。

Objective:To analyze the ultrasound diagnosis and imaging characteristics of patients with gallstone.Methods:From January 2018 to January 2020, 120 patients with suspected cholecystolithiasis were selected. Ultrasound diagnosis was performed in all the selected patients, and the ultrasound diagnosis results and imaging characteristics were analyzed compared with the surgical pathological diagnosis results.Results:From the point of the diagnosis, surgical pathologic diagnosis of 118 patients diagnosed with gallstones, diagnosis rate was 98.33%(118/120), type, full of 63 patients with typical gallstones gallbladder stones 34 cases, gallbladder neck 13 cases, sediment type stones 8 cases, ultrasound diagnosis of 114 patients diagnosed with gallstones, type, full of 61 patients with typical gallstones gallbladder stones 33 cases, 12 cases gallbladder neck stone stone in 8 cases, sediment sample type, the diagnosis coincidence rate was 96.61%(114/118). From the ultrasonographic features, typical gallbladder stones can be seen with rough gallbladder wall, high roughness, stable lumen shape, clear boundary, and strong echo group. If the body position is moved during the examination, the acoustic shadow and echo group in the rear will change accordingly. Thickening of the gallbladder wall can be seen in filled gallstones. In most cases, there is no obvious fluid acoustic cavity in the gallbladder. The posterior half of the gallbladder and the posterior wall are not fully displayed, and the triad of cystic wall, stone and acoustic shadow(WES syndrome) is clear. Gallbladder neck calculi can be seen in the upper part of the gallbladder neck and calculi incarcerated obviously under the background of bile on the cross section. The specific location of calculi cannot be determined. Gallbladder enlargement requires the change of position to the left forward position to better expose the calculi. Sediment type, the stones size differences, gallbladder stone characteristics, sedimentary thickness, grain big stones acoustic shadow mobility, and there is strong echo sedimentary zone, small particles of stone in gallbladder wall after rough, coarse feeling high, compared to the front wall, lateral wall and back wall echo, echo with the position changes occur tiny hairline strong echo.Conclusion:Ultrasound diagnosis of cholecystolithiasis can clarify the specific disease status, clear medical imaging and significant clinical value.