黄色肉芽肿性胆囊炎的超声表现及其病理学基础

Xanthogranulomatous cholecystitis:Sonographic, surgical and pathologic correlation

目的:明确黄色肉芽肿性胆囊炎的超声表现特征,以提高影像诊断的正确性. 方法:回顾性分析经手术病理证实的黄色肉芽肿性胆囊炎32 例的超声表现.男17例,女15例,年龄21-88(平均55.3岁). 结果:所有患者均有胆囊壁增厚,壁厚4-6 mm为15例(46.9%),7-10 mm 14例(43.8%),11-22 mm 3例(9.3%). 内壁光滑20例(62.5%),内壁不光滑12例(37.5%).壁间低回声结节5例(15.6%),壁间结石1例(3.1%).合并胆石症30例(93.8%),其中单纯胆囊结石22例(68.8%),单纯胆总管结石2例(6.3%),胆囊结石合并胆总管结石6例(18.8%). 浸润肝脏形成等回声或弱回声团块2例(6.3%). 结论:黄色肉芽肿性胆囊炎主要表现为胆囊壁不同程度增厚,可有壁内低回声结节,常伴有胆囊结石或胆管结石.超声检查可反映黄色肉芽肿性胆囊炎的病理改变.

AIM: To determine the sonographic features of xantho-granulomatous cholecystitis (XGC), which could improve imaging diagnosis. METHODS: The sonographic features of 32 patients with surgically resected XGC were retrospectively evaluated on the basis of the surgical and pathological findings. The patients were 15 women and 17 men, aged from 21 to 88 (mean 55.3) years. RESULTS: The gallbladder wall was thickened in all patients. Among the 32 cases, 15 (46.9%) were between 4 mm to 6 mm; 14 (43.8%) were between 7 mm to 10 mm; 3 (9.3%) were between 11 mm to 22 mm. On the membranous surface of the gallbladder wall, 20 (62.5%) were smooth, while 12 (37.5%) were uneven. Other manifestations included intramural hypoechoic nodule in 5 (15.6%), intramural cholelithiasis in 1 (3.1%), and cholelithiasis 30 (93.8%), respectively. Two patients (6.3%) had liver hypoechoic or iso-echoic mass resulted from the infiltration of XGC. CONCLUSION: Sonographic manifestations present thickened gallbladder wall, with intramural hypoechoic nodules and/or cholelithiasis. Sonographic examination can reveal the surgical and pathological findings of the XGC.