超声造影诊断非典型肝内胆管癌的价值.pdf

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1、临床急诊杂志2014年JournalofClinicalEmergency(China)15卷4期超声造影诊断非典型肝内胆管癌的价值*张明明宁艳婷罗渝昆张明博聂永康。吕发勤唐杰[摘要]目的：探讨超声造影在非典型肝内胆管癌诊断中的应用价值。方法：回顾性分析32例病理证实的非典型肝内胆管癌的超声造影表现，并与MRI诊断结果进行比较。结果：2位超声判读者的常规超声和造影的判读结果是一致的(．c一0．780、K一0．745)，同时超声造影与MR1结果具有关联性(P<0．05；rs一0．872)且一致性高(k一0．802)。超声造影的结果本组非典型肝内胆管癌超声造影主要表现为：①造影

2、后病灶边界清晰，显著提高了常规超声的检出率；②病灶相对小，其最大径(2．77士1．04)cm，未导致肝内胆管扩张，或扩张<5mm；③造影增强模式可为均匀增强或不均匀增强，动脉期增强程度呈多样性，可为偏低、偏高或等增强，门脉期可为低增强或等增强，但其共同特点是延迟期呈低增强。结论：肝内胆管癌早期无典型临床表现，对可疑患者的超声造影检查有利于鉴别非典型肝内胆管癌与其他肝肿瘤，从而使超声造影成为该病进一步治疗前可供选择的诊断方法。[关键词]肝内胆管癌；非典型；超声造影；诊断[中图分类号]R445．1[文献标志码]Adoi：10．13201／j．issn．1009—5918．201

3、4．04．004Diagnosticvalueofcontrast-enhancedultrasoundinatypicalintrahepaticcholangiocarcinomazHANGMingmingNINGYanting2LUOYukun2ZHANGMingbo2NlEYongkangLVFaqinTANGJie(DepartmentofU1trasonography，GanyuCountyPeople'sHospital，JiangsuGanyu222100，Chi—na；DepartmentofUItrasonography，GeneralHospitalo

4、fPLA；。DepartmentofRadiology，Gen—eralHospitalofPLA；DepartmentofUltrasonograraphy，HainanBranchofChinesePeopleSLiberationArmyGeneralHospita1)Correspondingauthor：LVFaqin，E—mail：lvjin8912@163．COrn；TANGJie，E—mail：txiner@vip．sina．cornAbstractObjective：Toinvestigatethevalueofcontrast-enhancedultra

5、sound(CEUS)inthediagnosisofa—typicalintrahepaticcholangiocarcinoma．Method：Tworeader'soutcomeofconventionalultrasoundandCEUSwereconsistent(K一0．780、K一0．745)．TherewascorrelationbetweenfindingsofCECTandMRIandhadhighconsis—tency(k一0．802)．Thecontrast-enhancedultrasonicmanifestationof32caseswitha

6、typicalintrahepaticcholangio—carcinomaconfirmedbypathologywerereviewedretrospectivelyandcomparedwiththeMRIfindings(P一0．000；RS=0．872)．Result：Themaincontrastenhancedultrasonicmanifestationofatypicalintrahepaticcholangiocarcino—maasfollows①CEUScouldrevealedborderclearlyandsignificantlyimprove

7、dtherateoflesiondetection．②Le—sionwasrelativelysmall，themaximumdiameterwas(2．77土1．04)cm，withouttheintrahepaticductsdistentionordilatationoflessthan5cm．③Contrastenhancementpatternsmightbehomogeneousoruneven．Theenhancedextentoflesionwasdiversityduringarterialand