黄色肉芽肿性胆囊炎12例超声误诊分析

Analysis of Ultrasound Misdiagnosis of 12 Cases of Xanthogranulomatous Cholecystitis

目的:通过分析黄色肉芽肿性胆囊炎(xanthogranulomatous cholecystitis,XGC)超声误诊原因,以提高对本病超声表现的认识。方法:回顾性分析了本院2018年1月~2020年12月术前超声误诊而经术后病理证实的12例XGC的临床资料、二维及彩色多普勒超声表现。结果:12例XGC均合并胆囊结石及胆囊壁增厚,其中弥漫性增厚7例,局限性增厚5例;超声发现肿块提示不除外胆囊癌可能4例,其中1例彩色多普勒显示肿块内可探及短线样血流信号。结论:XGC绝大多数病例存在胆囊壁增厚及胆囊结石,其应注意与胆囊癌的鉴别,超声提示胆囊壁黏膜线完整、壁间低回声结节、腹腔无淋巴结肿大以及彩色多普勒显示病变血流信号不丰富等倾向于XGC的诊断。

Objective:To analyze the causes of ultrasound misdiagnosis of xanthogranulomatous cholecystitis(XGC)to improve the understanding of the ultrasound manifestations of the disease.Methods:The clinical data,two-dimensional and color Doppler ultrasound findings of 12 cases of XGC that were misdiagnosed by preoperative ultrasound in our hospital from January 2018 to December 2020 and confirmed by postoperative pathology were retrospectively analyzed.Results:All 12 cases of XGC were associated with gallbladder stones and gallbladder wall thickening,including 7 cases of diffuse thickening and 5 cases of localized thickening.Ultrasound findings suggested that gallbladder cancer may not be excluded in 4 cases,of which 1 case showed a mass on color Doppler.The blood flow signal can be detected and short-term sampling.Conclusion:The majority of XGC cases have gallbladder wall thickening and gallbladder stones,which should be distinguished from gallbladder cancer.Ultrasound shows that the gallbladder wall mucosal line is intact,intermural hypoechoic nodules,no lymphadenopathy in the abdominal cavity,and color Doppler display Insufficient blood flow signals of lesions tend to be diagnosed by XGC.