彩色多普勒超声血流参数对良恶性胆囊疾病的鉴别诊断价值

Differential diagnostic value of blood flow parameters of color Doppler ultrasonography in benign and malignant gallbladder disease

目的探讨彩色多普勒超声血流参数对良恶性胆囊疾病的鉴别诊断价值。方法选取43例胆囊癌患者和20例胆囊炎患者,分别作为恶性组和良性组,两组患者均进行彩色多普勒超声检查,比较良性组和恶性组患者的血流参数[舒张末期流速(EDV)、搏动指数(PI)、平均流速(Vm)、收缩期峰值流速(PSV)和阻力指数(RI)],比较不同临床分期胆囊癌患者的彩色多普勒超声血流参数,采用受试者工作特征(ROC)曲线分析彩色多普勒超声血流参数对胆囊癌的诊断价值。结果恶性组患者的PSV、EDV、Vm均明显高于良性组,PI、RI均明显低于良性组,差异均有统计学意义(P﹤0.01)。Ⅳ期胆囊癌患者的PSV、EDV、Vm均高于Ⅰ、Ⅱ、Ⅲ期患者,PI、RI均低于Ⅰ、Ⅱ、Ⅲ期患者,差异均有统计学意义(P﹤0.05)。Ⅲ期胆囊癌患者的PSV、EDV、Vm均高于Ⅰ期患者,PI、RI均低于Ⅰ期患者,EDV高于Ⅱ期患者,PI低于Ⅱ期患者,差异均有统计学意义(P﹤0.05)。Ⅱ期胆囊癌患者的PSV、EDV、Vm均高于Ⅰ期患者,PI、RI均低于Ⅰ期患者,差异均有统计学意义(P﹤0.05)。彩色多普勒超声血流参数PSV、EDV、Vm、PI、RI联合检测诊断胆囊癌的灵敏度、特异度分别为95.35%、80.00%,均高于各参数单一检测。结论胆囊癌的彩色多普勒超声血流参数具有流速高、阻力小的特点,且与患者的临床分期有关,PSV、EDV、Vm、PI、RI联合检测对胆囊癌和胆囊炎的鉴别诊断价值较高。

Objective To analyze the differential diagnostic value of blood flow parameters of color Doppler ultrasonography in benign and malignant gallbladder disease.Method A total of 43 patients with gallbladder carcinoma and 20 patients with cholecystitis were divided into malignant group and benign group.All patients received color Doppler ultrasonography examination.The blood flow parameters[end-diastolic velocity(EDV),pulsatility index(PI),mean flow velocity(Vm),peak systolic velocity(PSV)and resistance index(RI)]in malignant group and benign group were compared.The above blood flow parameters of color Doppler ultrasonography in patients with different clinical stages of gallbladder carcinoma were compared.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of blood flow parameters of color Doppler ultrasonography in gallbladder carcinoma.Result The PSV,EDV and Vm in malignant group were higher than those in benign group,PI and RI were lower than those in benign group,and the differences were statistically significant(P<0.01).The PSV,EDV and Vm in stage IV patients with gallbladder carcinoma were higher than those in stage I,II and III patients,PI and RI were lower than those in stage I,II and III patients,and the differences were statistically significant(P<0.05).The PSV,EDV and Vm in stage III patients with gallbladder carcinoma were higher than those in stage I patients,PI and RI were lower than those in stage I patients,and EDV was higher than that in stage II patients,PI was lower than that in stage II patients,and the differences were statistically significant(P<0.05).The PSV,EDV and Vm in stage II patients with gallbladder carcinoma were higher than those in stage I patients,and PI and RI were lower than those in stage I patients,and the differences were statistically significant(P<0.05).The sensitivity,specificity of combined detection of blood flow parameters PSV,EDV,Vm,PI and RI of color Doppler ultrasonography in the diagnosis of gallbladder carcinoma were 95.35%,80.00%,respectively,which were higher than those of single detection of each parameter.Conclusion Blood flow parameters of color Doppler ultrasonography in gallbladder carcinoma patients are characterized by high velocity and low resistance,which are related to clinical stages of patients.Combined detection of PSV,EDV,Vm,PI,and RI has higher differential diagnostic value of gallbladder carcinoma and cholecystitis.