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目的 评价彩色多普勒超声对肝门部胆管癌的诊断价值。方法 对 42例经手术病理证实的肝门部胆管癌患者进行彩色多普勒超声检查 ,观察肿瘤内供血特点及肿瘤与门静脉之间的关系 ,并对误诊病例进行分析。结果 肝门部胆管癌的彩色血流显示率为 64 .3 % ,彩色血流显示率、门静脉受侵率与肿瘤大小无统计学相关性 ,本组病例超声诊断符合率为 71.4%。肝门部胆管癌需与原发性硬化性胆管炎、Mirizzi综合征、胆囊癌侵犯肝门部胆管、肝细胞癌胆管内癌栓等疾病鉴别。结论 彩色多普勒超声具有符合率高、操作简便、无损伤等特点 ,可评估肝门部胆管癌根治性切除的可能性 ,为临床外科提供了有益的帮助。
Objective To evaluate the diagnostic value of color Doppler ultrasound in hilar cholangiocarcinoma. Methods Forty-two patients with hilar cholangiocarcinoma confirmed by surgery and pathology were examined by color Doppler ultrasound. The characteristics of tumor blood supply and the relationship between tumor and portal vein were observed. The misdiagnosis cases were analyzed. Results The color flow rate of hilar cholangiocarcinoma was 64.3%. The color flow rate, portal vein invasion rate and tumor size were not statistically related. The coincidence rate of ultrasound diagnosis in this group was 71.4%. The hilar cholangiocarcinoma needs to be differentiated from primary sclerosing cholangitis, Mirizzi syndrome, gallbladder carcinoma invading the hilar bile duct, and hepatocellular carcinoma intrabiliary tumor thrombus. Conclusion Color Doppler ultrasound has the characteristics of high coincidence rate, simple operation, and no injury. It can evaluate the possibility of radical resection of hilar cholangiocarcinoma and provide useful help for clinical surgery.