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目的 探讨胆总管下段软组织病变的超声检查及其临床意义。 方法 对 87例胆总管下段软组织病变的超声诊断结果与手术病理或随访结果进行对照。 结果 超声检查怀疑胆总管癌 16例 ,术后病理诊断为胆总管癌 12例 ,壶腹癌 4例。超声检查怀疑壶腹癌 18例 ,术后病理诊断为壶腹癌 15例 ,胆总管癌 2例 ,软组织炎症 1例。超声检查拟诊为胰头癌 4 0例 ,均与术后病理诊断结论相符。超声检查怀疑十二指肠乳头癌 7例 ,术后病理诊断为十二指肠乳头癌 5例 ,壶腹癌 2例。胆总管癌合并胆总管下段结石 4例 ,其中 3例超声检查胆总管癌漏诊。2例超声诊断无法确定病变性质 ,随访结果为软组织炎症。超声诊断结果与病理诊断或临床随访结果相符率为 83.9%(73/87)。 结论 超声检查对胆总管下段软组织病变与胆总管结石容易鉴别 ,对软组织病变的良恶性病变鉴别有困难 ,必要时应结合十二指肠镜或 ERCP检查
Objective To investigate the ultrasonic examination of soft tissue lesions in the lower common bile duct and its clinical significance. Methods 87 cases of common bile duct soft tissue lesions in the ultrasound diagnosis and surgical pathology or follow-up results were compared. Results 16 cases of suspected cholecystodermal ultrasound examination, postoperative pathological diagnosis of choledochal carcinoma in 12 cases, ampullary carcinoma in 4 cases. Ultrasound examination of 18 cases suspected ampulla, pathological diagnosis of ampullary carcinoma in 15 cases, 2 cases of common bile duct cancer, soft tissue inflammation in 1 case. Ultrasound examination to be diagnosed as pancreatic cancer 40 cases were consistent with postoperative pathological diagnosis. Ultrasound examination suspected duodenal papillary carcinoma in 7 cases, postoperative pathological diagnosis of duodenal papillary carcinoma in 5 cases, ampullary carcinoma in 2 cases. Common bile duct cancer with common bile duct stones in 4 cases, of which 3 cases of missed diagnosis of cholecystolithiasis. Two cases of ultrasound diagnosis can not determine the nature of the disease, follow-up results for the soft tissue inflammation. The diagnostic results of ultrasound and pathological diagnosis or clinical follow-up results were 83.9% (73/87). Conclusion Ultrasound examination of common bile duct soft tissue lesions and common bile duct stones easy identification of soft tissue lesions of benign and malignant lesions difficult to identify, if necessary, combined with duodenoscopy or ERCP examination