原发性胆囊癌B超误诊原因分析

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本文分析经B超检查并手术和病理证实的30例原发性胆囊癌的误诊原因,其中假阳性25例,假阴性5例。误诊原因有:(1),充满型胆囊结石因弧形光带伴宽声影,掩盖了肿瘤声像不能显示;(2)只满足于发现胆囊结石,对伴有胆囊癌未引起重视,又缺乏多体位、多切面扫查,造成误诊;(3)胆囊不显像,无法判明胆囊的情况造成误诊;(4)将胆囊腔内蛔虫残体的声像误诊为胆囊癌;(5)因胆囊炎症致囊壁增厚且凸凹不平误诊为厚壁型胆囊癌;(6)胆囊腔内除见两块结石强光团外,还可见2.8×1.9cm较强光团但不伴声影,超声诊断为胆囊结石伴胆囊癌,手术证实不伴声影的较强光团系胆囊结石外周包裹了结缔组织所致;(7)B超与CT均诊断为胆囊癌伴胆囊周围癌浸润,手术和病理证实为胆固醇肉芽肿,胆囊壁由于炎症致使增厚并与周围肝组织粘连。 This article analyzed the causes of misdiagnosis of 30 cases of primary gallbladder carcinoma confirmed by B-ultrasound and confirmed by surgery and pathology. Among them, 25 cases were false positive and 5 cases were false negative. The reasons for misdiagnosis are: (1) Full-filled gallbladder stones are associated with wide acoustic shadows due to the curved light band, which masks the tumor image and cannot be displayed. (2) It is only satisfied with the discovery of gallbladder stones. No attention has been paid to gallbladder cancer. Lack of multi-position and multi-slice scans, resulting in misdiagnosis; (3) gallbladder inability to identify the gallbladder as a result of misdiagnosis; (4) misdiagnosing the gallbladder mutilated lesions as gallbladder cancer; (5) Thickening of the wall of the gallbladder wall due to inflammation of the gallbladder and misalignment are misdiagnosed as thick-walled gallbladder carcinoma; (6) In addition to the two stones in the gallbladder lumen, a strong light mass of 2.8 x 1.9 cm can be seen but not Acoustic imaging, ultrasound diagnosis of gallbladder stones with gallbladder carcinoma, surgery confirmed that no strong light group gallbladder stones with acoustic shadow wrapped around the surrounding connective tissue; (7) B-ultrasonography and CT were diagnosed as gallbladder cancer with gallbladder cancer Infiltration, surgery, and pathology confirmed cholesterol granuloma. The gallbladder wall thickened due to inflammation and adhered to the surrounding liver tissue.
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