自发性胆汁瘤的影像诊断及超声介入治疗价值

The value of imaging diagnosis and ultrasound-guided interventional therapy for spontaneous biloma

目的探讨自发性胆汁瘤的超声与CT表现特征及超声介入的疗效。方法回顾性分析19例自发性肝内外胆汁瘤患者的超声与CT表现,及行超声引导下置管引流的疗效分析。结果自发性胆汁瘤的超声及CT表现包括肝内单发或多发囊性占位、肝周囊性占位和上腹腔包裹性积液。上腹腔异常包括右上腹腔或剑下腹腔包裹性积液,胃窦、十二指肠及邻近肠系膜肿胀。19例患者行超声引导置管引流术后,17例胆汁瘤均闭合,患者症状好转,2例肝内多发胆汁瘤患者1月后死亡。结论超声及CT能够反映病理特征、累及范围和程度,超声引导置管引流术是治疗自发性胆汁瘤有效方法之一。

Objective This paper is to investigate the characteristics of ultrasound and CT in diagnosing spontaneous biloma and the therapeutic effect of ultrasound-guided intervention. Methods The ultrasound and CT features of 19 patients with spontaneous intrahepatic and extrahepatic biloma were analyzed retrospectively, and the effect of ultrasound-guided catheter drainage on patients was analyzed. Results The ultrasonographic and CT features of spontaneous biloma include single or multiple cystic lesions in the liver, perihepatic cystic lesions and peritoneal fluid inclusion. Abnormal upper abdominal cavity includes right upper abdominal cavity or subswordlike peritoneal fluid, gastric sinus, duodenum and adjacent mesentery swelling. After underwent ultrasound-guided catheterization and drainage, 17 cases of biloma were closed, the patients’ symptoms were improved, and 2 cases of intrahepatic multiple biloma died a month later. Conclusion Ultrasound and CT can accurately and comprehensively reflect the general pathological features and the affected body parts of spontaneous biloma. Ultrasound-guided catheter drainage is one of the effective methods to treat spontaneous biloma.