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目的 :评估胆管内超声检查 (IDUS)对胆管狭窄病因和分型的诊断价值。方法 :采用OlympusUM -G2 0 - 2 9R微型探头 (频率 2 0MHz)对 4 0例胆管狭窄病人于ERCP术中行胆管内超声 ,其中胆管癌 2 2例 ,胰头癌侵犯胆管 12例 ,胆管炎性狭窄 6例。结果 :胆管狭窄的IDUS分型为 1型 6例 ,2a型 1例 ,2b型 7例 ,3a型 2 1例 ,3b型 5例。良性狭窄 (胆管炎 )IDUS声像图特征为胆管壁肥厚、管腔狭窄伴壁内回声不均匀 ;恶性狭窄 (胆管癌、胰头癌侵犯胆管 )的IDUS图像特征为胆管壁肥厚、胆管外层高回声层不规则断裂。结论 :IDUS对明确胆管狭窄的原因和分类有一定价值。
Objective: To evaluate the diagnostic value of intraductal ultrasonography (IDUS) in etiology and classification of biliary strictures. Methods: Forty 40 patients with bile duct stricture underwent bile duct ultrasound (ERCP) with Olympus UM -G2 0-2 9R mini-probe (frequency: 20 MHz). Among them, 22 were cholangiocarcinoma, 12 were pancreatic ductal carcinoma infiltrating the bile duct, Stenosis in 6 cases. Results: IDUS classification of biliary stricture was type 1 in 6 cases, type 2a in 1 case, type 2b in 7 cases, type 3a in 21 cases and type 3b in 5 cases. Benign stenosis (cholangitis) IDUS sonography features of bile duct wall hypertrophy, stenosis with uneven echo within the wall; malignant stenosis (cholangiocarcinoma, pancreatic duct invasion of the bile duct) IDUS image features of bile duct wall hypertrophy, biliary duct High echo layer irregular rupture. Conclusion: IDUS has definite value in identifying the cause and classification of biliary stricture.