摘要
目的探讨超声造影对壶腹部周围癌诊断和鉴别诊断的临床价值。方法回顾分析22例壶腹部周围癌超声造影表现，全部病例均经手术病理证实，其中胆总管下段癌9例，壶腹癌5例，乳头癌3例，胰头癌5例。观测指标包括病灶大小及造影前后病灶的清晰显示率、增强开始时间和消退时间、增强水平及增强形态。结果造影后病灶清晰显示率从造影前55％（12／22）提高到95％（21／22）；病灶增强开始时间、消退时间和增强水平差异无统计学意义（P〉0．05），而增强形态和最大直径则明显不同：胰头癌多呈不均匀增强，管腔内均未显示突出物及“半月征”，病灶直径显著大于胆总管下段癌、壶腹癌及乳头癌（P〈0．05），后三者病变多呈均匀增强，管腔内均显示突出物和（或）“半月征”。结论超声造影可显著提高壶腹部周围癌的清晰显示率，有助于病灶的定性诊断；病灶大小和增强形态对壶腹部周围癌的鉴别诊断具有重要的实用价值。
Objective To evaluate the value of contrast-enhanced ultrasound（CEUS） in diagnosis and differential diagnosis of periampullary carcinoma. Methods Twenty-two cases of periampullary carcinoma confirmed by pathology and performed CEUS. They were carcinoma of common bile duct 9 cases, carcinoma of ampulla of Vater 5 cases, carcinoma of duodenal papilla 3 cases and carcinoma of head of pancreas 5 cases. The clearly displaying rate was compared before and after CEUS. The size of lesions, enhancement parameters of beginning time, fading time, intensity and styles were observed. Results The clearly displaying rate of the lesions was improved from55% （12/22） to 95% （21/22） after administering contrast media （SonoVue）. There were no significant differences in enhancement beginning time, fading time and intensity among lesions （ P〉 0.05）. The size of lesions and enhancement styles were obviously different between carcinoma of head of pancreas and other lesions： the size of carcinoma of head of pancreas was bigger （P 〈 0.05 ）. The most common enhancement style in carcinoma of head of pancreas was heterogeneous,the tumor＇s protruding into luminal and ＇half-moon＇ sign were not observed; carcinoma of common bile duct, carcinoma of ampulla of Vater, carcinoma of duodenal papilla were homogenous, the tumor＇s protruding into luminal and ＇half moon＇ sign were observed. Conclusions CEUS can significantly improve the clearly displaying rate of periampullary carcinoma, and its qualitative diagnosis; the sizes of lesions and enhancement styles have important value in differential diagnosis of periampullary carcinoma.
出处
《中华超声影像学杂志》
CSCD
北大核心
2009年第10期847-850,共4页
Chinese Journal of Ultrasonography
关键词
超声检查
微气泡
肝胰管壶腹
消化系统肿瘤
鉴别诊断
Ultrasonography
Microbubbles
Ampulla of Vater
Digestive system neoplasms
Diagnosis, differential
