CAJ | 학술논문

目的：探讨三维超声联合超声造影在肝门胆管癌术前评估中的作用。方法回顾性分析41例经手术和病理证实的肝门胆管癌患者资料，术前均行三维超声及超声造影，观察三维超声及超声造影表现，并与手术及病理对照分析。结果41例肝门胆管癌患者中，三维超声判断Bismuth-Corlette分型的准确率为85.4％（35/41），磁共振胰胆管造影（MRCP）的准确率为87.8%（36/41），比较两种方法的分型结果，差异无统计学意义（χ2=0.94，P>0.05）。超声造影检测的灵敏度、特异度和准确率如下：肝门胆管癌淋巴结转移（72.7％、93.3％、87.8％）、肝转移（71.4％、97.1％、92.7％）、肝动脉受侵（85.7％、97.1％、95.1％）、门静脉受侵（87.5％、97.0％、95.1％）。三维超声联合超声造影对肝门胆管癌术前可切除性评价与术中评价的一致率为78.0％（32/41），差异无统计学意义（χ2=0.86，P>0.05）。结论三维超声联合超声造影在判断肝门胆管癌分型、检测淋巴结和肝内转移、评估血管侵犯方面具有重要价值。
목적：탐토삼유초성연합초성조영재간문담관암술전평고중적작용。방법회고성분석41례경수술화병리증실적간문담관암환자자료，술전균행삼유초성급초성조영，관찰삼유초성급초성조영표현，병여수술급병리대조분석。결과41례간문담관암환자중，삼유초성판단Bismuth-Corlette분형적준학솔위85.4％（35/41），자공진이담관조영（MRCP）적준학솔위87.8%（36/41），비교량충방법적분형결과，차이무통계학의의（χ2=0.94，P>0.05）。초성조영검측적령민도、특이도화준학솔여하：간문담관암림파결전이（72.7％、93.3％、87.8％）、간전이（71.4％、97.1％、92.7％）、간동맥수침（85.7％、97.1％、95.1％）、문정맥수침（87.5％、97.0％、95.1％）。삼유초성연합초성조영대간문담관암술전가절제성평개여술중평개적일치솔위78.0％（32/41），차이무통계학의의（χ2=0.86，P>0.05）。결론삼유초성연합초성조영재판단간문담관암분형、검측림파결화간내전이、평고혈관침범방면구유중요개치。
Objective To investigate the application value of three-dimensional ultrasonography (3D-US) combined with contrast-enhanced ultrasonography (CEUS) in the preoperative resectability assessment of hilar cholangiocarcinoma (HC). Methods The clinical data of 41 patients with HC confirmed by surgery and pathology were retrospectively analyzed. Preoperative 3D-US and CEUS were performed and the results were compared with surgical and pathological findings. Results The accuracy of the Bismuth-Corlette classification confirmed by 3D-US and MRCP was 85.4% (35/41) and 87.8% (36/41), respectively. The difference between the two methods was not statistically significant (χ2=0.94, P>0.05). The sensitivity, specificity, and accuracy of CEUS for diagnosing lymph node metastasis,hepatic metastasis, hepatic artery invasion, and portal vein invasion of HC were 72.7%, 93.3%, 87.8%;71.4%, 97.1%, 92.7%;85.7%, 97.1%, 95.1%;87.5%, 97.0%, 95.1%, respectively. The consistency between preoperative evaluation of resectability confirmed by 3D-US combined with CEUS was 78.0%(32/41). And the evaluations had no statistically significant differences (χ2=0.86, P>0.05). Conclusion 3D-US combined with CEUS and surgery has significant value in the classification of HC and resectability assessment of lymph node metastasis, hepatic metastasis and vessel invasion.