CAJ | 학술논문

目的探讨胆囊隆起性病变超声造影的血流灌注过程及其增强模式,评价其应用价值.方法对47例胆囊隆起性病变进行彩色多普勒超声和造影超声检查,观察胆囊壁及病变的增强时间和增强模式.结果经手术病理证实的47例中良性病变35例,恶性病变12例.彩色多普勒超声检出病变内血流信号19例(40%,19/47);超声造影增强病例38例(81%,38/47),P<0.005.胆囊壁平均始增时间为(16.2±1.9)s,良性病变平均始增时间(16.3±2.8)s,恶性病变平均始增时间(16.2±3.2)s,未见明显统计学差异(P=0.92).47例胆囊隆起性病变增强模式分为4类:Ⅰ类:无增强;Ⅱ类:动脉相均匀增强;Ⅲ类:动脉相蜂窝状不均匀增强;Ⅳ类:动脉相血管呈杂乱树枝状高增强.所有良性病变造影模式分别表现为Ⅰ类到Ⅲ类,11例(92%,11/12)恶性病变表现为Ⅳ类,1例表现为Ⅲ类.11例恶性病例动脉相胆囊壁局部连续性显示中断.结论超声造影可显示胆囊隆起性病变的血流灌注过程.特征性的增强模式,可以提高鉴别诊断能力.动脉相胆囊壁显示是否完整连续对鉴别良恶性有意义.
목적 탐토담낭륭기성병변초성조영적혈류관주과정급기증강모식,평개기응용개치.방법 대47례담낭륭기성병변진행채색다보륵초성화조영초성검사,관찰담낭벽급병변적증강시간화증강모식.결과 경수술병리증실적47례중량성병변35례,악성병변12례.채색다보륵초성검출병변내혈류신호19례(40%,19/47);초성조영증강병례38례(81%,38/47),P<0.005.담낭벽평균시증시간위(16.2±1.9)s,량성병변평균시증시간(16.3±2.8)s,악성병변평균시증시간(16.2±3.2)s,미견명현통계학차이(P=0.92).47례담낭륭기성병변증강모식분위4류:Ⅰ류:무증강;Ⅱ류:동맥상균균증강;Ⅲ류:동맥상봉와상불균균증강;Ⅳ류:동맥상혈관정잡란수지상고증강.소유량성병변조영모식분별표현위Ⅰ류도Ⅲ류,11례(92%,11/12)악성병변표현위Ⅳ류,1례표현위Ⅲ류.11례악성병례동맥상담낭벽국부련속성현시중단.결론 초성조영가현시담낭륭기성병변적혈류관주과정.특정성적증강모식,가이제고감별진단능력.동맥상담낭벽현시시부완정련속대감별량악성유의의.
Objective Study on contrast-enhanced ultrasound (CEUS)in elevated lesions of gallbladder.Methods Forty-seven lesions of gallbladder were performed by color Doppler ultrasound (CDUS) and CEUS examinations.The beginning enhancement time of gallbladder wall and enhance pattern of the lesions were recorded.Results There were 35 benign lesions and 12 malign lesions among 47 cases.Blood flow among nineteen (40%,19/47)lesions were detected out by CDFI,but 38(81%,38/47)lesions were enhanced by CEUS(P<0.005).The beginning enhancement time of gallbladder wall,benign lesions,malignant lesions were 16.2±1.9s,16.3±2.8s,16.2±3.2s,respectively(P=0.92).The enhance pattern of the lesions were divided into four types.Type Ⅰ:no enhancement;Type Ⅱ:uniform enhancement;Type Ⅲ:alveolate inequable enhancement;Type Ⅳ:tortuous-branched enhancement.All of the benign lesions were from type Ⅰ to type Ⅲ.Eleven(92%) malignant lesions were type Ⅳ.Eleven malignant lesions showed series intervals in gallbladder wall during arterial phase.Conclusions The CEUS could describe the dynamic blood perfusion of gallbladder lesions.It was useful for differentiating benign from malignity lesions.