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目的:探讨超声造影对胆囊胆固醇性息肉的诊断及临床应用价值。材料与方法:对照手术病理结果,回顾性分析总结38例46枚胆囊胆固醇性息肉的超声影像资料。常规超声观察息肉的大小、形态、回声、彩色多普勒血流以及胆囊壁是否光滑完整,超声造影以同深度的肝脏增强方式作为参考,实时观察胆囊壁及息肉的增强时相及增强模式。结果:常规超声表现38例46枚胆囊胆固醇性息肉中,直径4~25 mm,平均9.5 mm,<10 mm 33枚,≥10 mm 13枚;单发9例,多发29例,多发时选取最大一枚进行观察,或在同一切面上观察多枚病灶;菜花形21枚,长椭圆形10枚,乳头状15枚。彩色多普勒显示10枚胆囊息肉内测及血流信号(10/46),其中<10 mm 4枚,≥10 mm 6枚。实时超声造影显示:增强方式上,46枚病灶均有增强,胆囊壁光滑整齐与病灶界限清晰,其中:高增强39枚(39/46),等增强7枚(7/46);病灶动脉期增强快于肝实质38枚(38/46),与肝实质同步8枚(8/46);蜂窝样增强31枚(31/46),整体增强15枚(15/46);在减退方式上,慢于肝实质减退36枚(36/46),与肝实质同步减退10枚(10/46);29枚病灶可见明显的蒂。结论:超声造影可提高胆囊胆固醇性息肉的血流显示率;蜂窝样增强,基底较窄,可见蒂,慢于或同步于肝实质减退是诊断胆囊胆固醇性息肉的主要超声表现;超声造影为临床选择治疗方式提供依据,具有重要的参考价值。
Objective: To investigate the diagnostic value and clinical value of contrast-enhanced ultrasound in the diagnosis of gallbladder polyps. Materials and Methods: According to the surgical pathology results, retrospective analysis of 38 cases of 46 gallbladder polyps of cholesterol ultrasound imaging data. Conventional ultrasound was used to observe the size, shape, echogenicity, color Doppler flow and the gallbladder wall of the polyps, and to observe the enhanced phase and enhancement mode of the gallbladder wall and polyps in real time with the same method of enhancement of the liver. Results: The results of routine ultrasonography showed that there were 46 gallbladder polyps in 38 patients with diameter of 4 ~ 25 mm (average 9.5 mm, <10 mm, 33 pieces, ≥ 10 mm). Nine cases were single and 29 cases were multiple. One for observation, or in the same section to observe multiple lesions; Cauliflower-shaped 21, 10 oval, papillary 15. Color Doppler ultrasound showed 10 gallbladder polyps and blood flow signals (10/46), of which 4 were <10 mm and 6 were ≥10 mm. Real-time contrast-enhanced ultrasound showed that 46 lesions were enhanced in the enhancement mode, the gallbladder wall was smooth and neat, and the boundaries of the lesions were clear. Among them, 39 (39/46) were highly enhanced and 7 (7/46) Enhanced 38 (38/46) faster than the parenchyma and 8 (8/46) synchronized with the parenchyma of the liver; 31 (31/46) had a honeycomb-like enhancement and 15 (15/46) as a whole; , 36 (36/46) slower than that of the parenchymal liver, 10 (10/46) decreased synchronously with the parenchymal liver; 29 lesions showed obvious pedicle. CONCLUSION: Contrast-enhanced ultrasound can improve the rate of blood flow in gallbladder polyps. The honeycomb-like enhancement and narrow basement can be seen pedicled with slow, slow or synchronous hepatic parenchyma, which is the main ultrasonographic diagnosis of gallbladder polyps. Ultrasonography is clinically Select the basis for treatment, has important reference value.