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目的探讨原发性胆囊癌的影像学误诊原因及预防误诊的措施。方法回顾分析胆囊切除1316例患者的临床资料,其中48例原发性胆囊癌患者,术前因影像学判断误诊13例,分析其误诊原因探讨预防误诊的措施。结果 48例患者正确诊断有效率为72.9%,13例患者误诊(27.1%),其中误诊为慢性胆囊炎、胆结石5例,胆管结石3例,胆囊息肉2例,胆管癌1例,胰头癌1例,胆囊缺如1例。结论 13例误诊患者的诊治分析,其误诊原因为过分依赖影像学,对病情认识不足,未进行进一步MIR确诊。医生需提高对胆囊癌影像学表现认识,对可疑病例术前应做全面完善的检查,以免漏诊、误诊。
Objective To investigate the causes of misdiagnosis of imaging gallbladder carcinoma and the preventive measures of misdiagnosis. Methods The clinical data of 1316 patients undergoing cholecystectomy were retrospectively analyzed. Among 48 patients with primary gallbladder carcinoma, 13 cases were misdiagnosed by imaging diagnosis before operation, and the causes of misdiagnosis were analyzed. Results The correct diagnostic accuracy was 72.9% in 48 patients and 27.1% in 13 patients. Chronic cholecystitis was misdiagnosed in 5 patients, gallstone in 3, gallbladder polyp in 2, cholangiocarcinoma in 1, 1 case of cancer, 1 case of absence of gallbladder. Conclusions The diagnosis and treatment of 13 cases of misdiagnosis were misdiagnosed as over-reliance on imaging, lack of knowledge of the disease and no further MIR diagnosis. Doctors need to improve understanding of the imaging findings of gallbladder cancer, the suspect cases should be done before and after the comprehensive examination, so as to avoid misdiagnosis.