超声检查对黄色肉芽肿性胆囊炎的诊断价值

Value of ultrasonography in diagnosis of xanthogranulomatous cholecystitis

目的:通过比较黄色肉芽肿性胆囊炎(XGC)和厚壁型胆囊癌的超声征象,评估超声检查对XGC的诊断价值。方法:回顾性分析经病理学检查诊断的31例XGC和36例厚壁型胆囊癌患者的临床表现和超声图像资料,收集胆囊壁厚度、胆囊壁厚的范围、胆囊壁内有无低回声结节、胆囊黏膜线是否连续、胆囊或胆管内有无结石、胆道有无扩张及胆囊—肝脏分界是否清晰等超声征象并进行对照分析。结果:XGC组胆囊壁内低回声结节、胆囊内壁黏膜线连续以及胆道扩张与厚壁型胆囊癌组比较差异均有统计学意义(均P<0.05),而其余超声征象在两组间差异无统计学意义(均P>0.05)。其中,胆囊壁内低回声结节和胆囊内壁黏膜线连续诊断XGC具有较高的准确度,分别为64.2%和65.7%。结论:增厚的胆囊壁内低回声结节、胆囊壁内黏膜线连续是XGC较具特征性的超声表现。

Objective: To assess the value of ultrasonography in differential diagnosis of xanthogranulomatous cholecystitis( XGC) and wall-thickening type of gallbladder cancer(GBC). Methods : The clinical features and sonographic finding of31 patients with XGC and 36 patients with wall-thickening type of GBC were retrospectively reviewed. The diagnosis of all cases was confirmed by pathological examination, and the ultrasonographic manifestations of the thickening of the gallbladder wall, intramural hypoechoic nodules, gallbladder mucosa line, gallbladder stones,biliary dilatation and gallbladder-liver boundary were compared between two groups.Results: There were significant differences in the intramural hypoechoic nodules, the continuous gallbladder wall mucosal line and dilatation of bile duct between XGC and GBC groups(all P <0.05), while no statistically significant differences in the other sonographic features(all P >0.05). In the six positive sonographic features of the XGC patients, the intramural hypoechoic nodules and the continuous mucosa line of the gallbladder wall had highest accuracy in the diagnosis of XGC(64. 2% and 65. 7%).Conclusion : Intramural hypoechoic nodule and the continuous mucosal line are characteristic sonographic features of XGC, which can be used for the diagnosis of XGC.