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目的探讨超声造影对肝外胆道梗阻性病变病例声像图特点及其病因诊断之临床价值。方法对33例肝外胆道梗阻性病变患者行常规超声及超声造影检查,并与术后病理结果对照。结果 33例病变中良性梗阻病变17例(胆总管下段结石伴胆泥沉积6例,胆总管炎性狭窄11例)。恶性梗阻病变16例(胆总管癌及壶腹周围癌)。与术后病理诊断对照二维超声联合彩色多普勒超声准确诊断18例,诊断准确率为54.5%,二维超声联合超声造影准确诊断30例,准确率为90.9%。结论二维超声联合超声造影对诊断肝外胆管梗阻性病变的准确率优于单纯二维超声联合彩色多普勒超声。
Objective To investigate the diagnostic value of contrast-enhanced ultrasonography in the diagnosis of extrahepatic biliary obstructive lesions and its etiological diagnosis. Methods Thirty-three patients with extrahepatic biliary obstructive lesions underwent routine ultrasonography and contrast-enhanced ultrasonography, and were compared with postoperative pathological results. Results Of the 33 lesions, 17 cases had benign obstructive lesions (6 cases of common bile duct stones with biliary sediment and 11 cases of common bile duct inflammatory stenosis). 16 cases of malignant obstruction (common bile duct cancer and periampullary cancer). 18 cases were correctly diagnosed by color Doppler ultrasound combined with two-dimensional ultrasound combined with postoperative pathological diagnosis, the diagnostic accuracy rate was 54.5%. Thirty cases were accurately diagnosed by two-dimensional ultrasonography combined with contrast-enhanced ultrasound with the accuracy of 90.9%. Conclusion The accuracy of two-dimensional ultrasonography combined with contrast-enhanced ultrasound in the diagnosis of extrahepatic bile duct obstruction is better than that of simple two-dimensional ultrasound and color Doppler ultrasound.