摘要
目的探讨彩色多普勒超声检查(彩超)在婴幼儿囊性胆道闭锁(CBA)和胆总管囊肿(CC)鉴别诊断中的价值。方法前瞻性研究对象为2012年1月至2014年7月在中山大学附属第一医院诊断为肝门部囊性病变并接受手术治疗的54例患儿。其中男35例,女19例;平均年龄(63±19)d。根据病理学检查结果分为CBA组和CC组。所有患儿监护人均签署知情同意书,符合医学伦理学规定。记录术前TB、DB水平。采用彩超观察肝门部纤维块、肝内胆管扩张、囊肿内胆泥沉积发生情况,并测量胆囊长径和宽径及肝动脉内径。两组观察指标比较采用χ2检验或t检验。结果CBA组肝门部纤维块发生率为96%(25/26),明显高于CC组的0(0/28)(P<0.05);CBA组肝内胆管扩张、囊肿内胆泥沉积发生率均为0(0/26),明显低于CC组的75%(21/28)和54%(15/28)(P<0.05);CBA组胆囊宽径为(5±1)mm,明显小于CC组的(8±2)mm(t=-38.68,P<0.05);CBA组肝动脉内径为(2.4±0.4)mm,明显大于CC组的(1.8±0.3)mm(t=28.40,P<0.05)。结论肝门部纤维块、肝内胆管扩张、囊肿内胆泥沉积、胆囊宽径和肝动脉内径是彩超鉴别CBA和CC的有效指标,可用于指导术前鉴别诊断。
Objective To explore the value of color Doppler ultrasonography（CDU） in the differential diagnosis of cystic biliary atresia（CBA） and choledochal cyst（CC） in infants. Methods A total of 54 infants diagnosed with hepatic portal cystic lesion in the First Affiliated Hospital of Sun Yat-sen University from January 2012 to July 2014 who were going to receive surgical treatment were included in this prospective study. Of the 54 cases, 35 were baby boys and 19 were baby girls with a mean of（63±19） d old. According to the results of pathological examination, the patients were divided into the CBA group and the CC group.All guardians of the infants signed the informed consent and the local ethical committee approval had been received. Preoperative TB level and DB level were recorded. CDU was used to observe the incidence of hepatic portal fibrous mass, intrahepatic bile duct dilation and biliary sludge sedimentation in the cyst. In addition, the length diameter and width diameter of gallbladder and the inner diameter of hepatic artery were measured. The observed parameters of two groups were compared by χ2 test or t test. Results The incidence of hepatic portal fibrous mass in CBA group was 96%（25/26）, which was significantly higher than 0（0/28） in CC group（P〈0.05）. The incidence of intrahepatic bile duct dilation and biliary sludge sedimentation in the cyst in CBA group were both 0（0/26）, which were significantly lower than 75%（21/28） and 54%（15/28） in CC group（P〈0.05）. The width diameter of gallbladder in CBA group was（5±1） mm, which was significantly less than（8±2） mm in CC group（t=-38.68, P〈0.05）. The inner diameter of hepatic artery in CBA group was（2.4±0.4） mm, which was significantly greater than（1.8±0.3） mm in CC group（t=28.40, P〈0.05）. Conclusions The hepatic portal fibrous mass, intrahepatic bile duct dilation, biliary sludge sedimentation in the cyst, width diameter of gallbladder and inner diameter of hepatic artery are effectiv
出处
《中华肝脏外科手术学电子杂志》
CAS
2015年第2期39-42,共4页
Chinese Journal of Hepatic Surgery(Electronic Edition)
基金
国家自然科学基金(81301330
81301331)
关键词
超声检查
胆道闭锁
胆总管囊肿
黄疸
新生儿
Ultrasonography
Biliary atresia
Choledochal cyst
Jaundice, neonatal
