论文部分内容阅读
目的评价经腹高分辨力超声(HRUS)在鉴别诊断胆囊腺肌增生症和早期厚壁型胆囊癌的价值。方法高分辨力超声(HRUS)是指有别于传统低频超声成像,使用了先进的成像技术具有更高组织对比度和空间分辨力的高频超声成像。回顾性分析45例胆囊腺肌增生症病人和28例T1/T2期厚壁型胆囊癌病人的HRUS成像结果。3位超声专家采用双盲法,根据诊断疾病信心指数进行5分法独立评分,应用受试者操作特征曲线评价HRUS在胆囊腺肌增生症和早期厚壁型胆囊癌鉴别诊断中的价值。同时3位专家也对形态学的异常进行分析。结果应用高分辨力超声诊断胆囊腺肌增生症,3位专家得出的受试者操作特征曲线下面积(Az)的结果分别为0.948、0.915和0.917。胆囊壁均匀性增厚、胆囊壁内囊性腔隙、胆囊壁内强回声灶及快闪的伪像等超声表现与胆囊腺肌增生症呈显著相关(P<0.05),而胆囊外壁不规则增厚、最内膜高回声带(IHL)局部不连续、IHL不规则、IHL增厚大于1mm、胆囊壁多层结构消失、病灶内可见血管等超声表现均与胆囊癌呈显著相关(P<0.05)。胆囊壁内囊性腔隙、胆囊壁内强回声灶对诊断腺肌增生症的敏感度、特异度和准确度分别为80.0%、85.7%和82.2%。结论本研究表明HRUS有助于鉴别胆囊腺肌增生症和早期厚壁型胆囊癌。要点①经腹HRUS有助于鉴别腺肌增生症和胆囊癌。②HRUS可以评估胆囊壁的详细解剖情况。③胆囊腺肌增生症在HRUS上有特征性表现。
Objective To evaluate the value of transabdominal high resolution ultrasound (HRUS) in the differential diagnosis of gallbladder glandular hyperplasia and early stage gallbladder carcinoma. Methods High-resolution ultrasound (HRUS) refers to high-frequency ultrasound imaging that is distinguished from conventional low-frequency ultrasound imaging using advanced imaging techniques with higher tissue contrast and spatial resolution. Retrospective analysis of 45 cases of glandular adenomyosis and 28 cases of T1 / T2 stage gallbladder cancer patients HRUS imaging results. Three ultrasound experts used a double-blind method to independently score the five-point scale according to the diagnosis of disease confidence index. The value of HRUS in the differential diagnosis of gallbladder glandular hyperplasia and early-stage thick-walled gallbladder cancer was evaluated using the operating characteristic curve of the subject. At the same time three experts also analyzed morphological abnormalities. Results High resolution sonography was used to diagnose glandular gland hyperplasia. The area under the operating characteristic curve (Az) of three experts was 0.948, 0.915 and 0.917, respectively. Thickened gallbladder wall, cystic cavity in the gallbladder wall, strong echo in the gallbladder wall and flash artifacts and other ultrasonographic manifestations of glandular hyperplasia was significantly associated with gallbladder (P <0.05), and irregular gallbladder wall Thickening, the most intima-mediaic echo (IHL) was discontinuous, the IHL was irregular, IHL was thicker than 1mm, the multi-layer structure of gallbladder wall disappeared. The intravascular ultrasonographic findings were significantly correlated with gallbladder carcinoma (P < 0.05). The sensitivity, specificity and accuracy of the cystic cystic space in the gallbladder wall and the echogenic zone in the gallbladder wall were 80.0%, 85.7% and 82.2% respectively for the diagnosis of adenomyosis. Conclusion This study shows that HRUS can help differentiate GGH and early gallstone carcinoma. Tips ① Abdominal HRUS helps to identify adenomyosis and gallbladder cancer. ② HRUS can assess the detailed anatomy of the gallbladder wall. ③ gallbladder adenomyosis has a characteristic performance in the HRUS.