超声造影中不同胆囊良恶性病变的鉴别诊断价值

Differential Diagnosis Value of Different Benign and Malignant Lesions of Gallbladder in Ultrasonography

目的分析超声造影中不同胆囊良恶性病变的鉴别诊断价值。方法纳入2019年1月至2019年12月开封市祥符区第一人民医院接收的90例胆囊良恶性病变患者,所有患者均进行常规超声检查联合造影检查,进一步观察肝转移状况、胆囊壁、周围组织进入状况,并分析胆囊病变血流特点。结果90例胆囊良恶性病变患者中,胆囊良性病变检出总计57例(63.33%);其中,胆囊腺瘤2例(3.51%),胆囊增生症12例(21.05%)和胆囊息肉43例(75.44%),胆囊恶性肿瘤检出总计33例(36.67%),其中胆囊癌并侵犯肝脏、腺瘤癌变、胆囊腺癌分别有1例(3.03%)、5例(15.15%)、27例(81.82%)。其中,大部分胆囊良性病变形态规则,无胆囊结石,基底窄。通过超声造影检查提示,均匀增强,胆囊壁结构未被破坏,相对完整。大多数胆囊恶性病变以不规则形态呈现,基底窄,囊壁分解模糊,且伴有胆囊结石。诊断准确率方面,常规超声是91.11%,超声造影是98.89%,超声造影比常规超声高,差异有统计学意义(P<0.05)。结论胆囊良性与恶性病变临床诊断过程中,超声造影的应用具有明显效果,其能够清晰地展现血流及胆囊病变状况,具体有胆囊壁、血流灌注等,以便更好的诊断疾病,值得临床进一步采纳与应用。

Objective To analyze the differential diagnostic value of different benign and malignant lesions of gallbladder in contrast-enhanced ultrasonography.Methods A total of 90 patients with benign and malignant gallbladder lesions received in our hospital from January 2019 to December 2019 were randomLy selected.All patients underwent routine ultrasonography combined with contrast-enhanced examination.The liver metastasis,gallbladder wall and surrounding tissue entry were further observed,and the blood flow characteristics of gallbladder lesions were analyzed.Results Among 90 patients with benign and malignant gallbladder lesions,57 cases(63.33%)were detected as benign gallbladder lesions;Among them,there were 2 cases of gallbladder adenoma(3.51%),12 cases of gallbladder hyperplasia(21.05%)and 43 cases of gallbladder polyps(75.44%),and 33 cases of gallbladder malignant tumors(36.67%),among them,there were 1(3.03%),5(15.15%),27(81.15%)and 27(81.82%)of gallbladder cancer and invade the liver,adenoma carcinogenesis,gall bladder adenocarcinoma.Among them,most benign lesions of gallbladder have regular shape,no gallstone and narrow base.Contrast-enhanced ultrasonography showed that the gallbladder wall structure was not damaged and relatively intact.Most malignant lesions of gallbladder appear in irregular shape,with narrow base,vague decomposition of cystic wall,and accompanied by gallstones.In terms of diagnostic accuracy,ultrasonography was 98.89%,significantly higher than conventional ultrasound of 91.11%(P<0.05).Conclusion In the clinical diagnosis of benign and malignant lesions of gallbladder,the application of ultrasonography has obvious effect.It can clearly show the blood flow and gallbladder lesions,including gallbladder wall and blood perfusion,so as to better diagnose the disease,which is worthy of further adoption and promotion in clinic.