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目的:应用二维及彩色多普勒超声检查对肝门胆管癌(Klatskin’s肿瘤)作出综合评价。方法:回顾性研究111例Klatskin’s肿瘤术前超声图像表现与同期开腹探查手术及病理图所见进行对照分析。结果:Klatskin’s肿瘤声像图表现与分型在获得病变检出率97％和超声诊断符合率94.5％基础上,大致分为中等回声肿块型(含乳头或结节型)63例;强回声浸润型(含截断狭窄型)43例。按Bismuth分型,肿瘤部位判断符合率:Ⅰ、Ⅱ型为98％,Ⅲ型或Ⅳ型为81％;肿瘤浸润范围判断符合率,包括肝实质、门静脉、肝动脉、肝门淋巴结分别为87％、83％、69％、41％。术前进行了切除可行性判断。结论:评价Klatskin’s肿瘤,就单纯运用而言,超声检查仍然是目前最好的影像学方法之一。然而,提高肝门胆管癌的诊断及治疗水平,超声影像医生与外科医生将同等重要。
OBJECTIVE: To make a comprehensive evaluation of hilar cholangiocarcinoma (Klatskin’s tumor) with two-dimensional and color Doppler ultrasonography. Methods: A retrospective study of 111 cases of Klatskin’s tumor preoperative ultrasound imaging performance and concurrent exploration of open surgery and pathological findings were analyzed. Results: Klatskin’s tumor sonography showed that the detection rate of lesion was 97% and the coincidence rate of ultrasound diagnosis was 94.5%, which was roughly divided into moderate echo mass type (including papilla or nodule type) 63 cases; hyperechoic infiltration Type (including truncated narrow type) in 43 cases. According to the Bismuth classification, the coincidence rates of the tumor sites were 98% for type Ⅰ and type Ⅱ, and 81% for type Ⅲ or type Ⅳ. The coincidence rate of tumor infiltration range including hepatic parenchyma, portal vein, hepatic artery and hepatic portal lymph node were 87 %, 83%, 69%, 41%. Preoperative resection feasibility assessment. CONCLUSIONS: To evaluate Klatskin’s tumor, ultrasonography is still one of the best imaging methods available for simpler purposes. However, improving the diagnosis and treatment of hilar cholangiocarcinoma will be equally important for ultrasound imaging surgeons and surgeons.