CAJ | 학술논문

目的分析评价壶腹部癌的双重对比超声造影(DCUS)效果,提高超声对该病的诊断价值.方法回顾性分析40例经病理证实壶腹部癌患者的DCUS及临床资料.结果 (1)DCUS对病灶显示率和对病灶位置的判定准确性明显高于普通超声(P＜0.05).(2)壶腹部癌的DCUS表现:除一例未发现病灶外,病灶多小于30 mm;100％(39/39)病灶形态均固定;64.1％ (25/39)表现动脉期高或等增强,静脉期低增强;87.2％ (34/39)增强均匀;95％ (38/40)胆管中重度扩张.三种不同类型癌病灶的位置、是否突向十二指肠腔的差异有统计学意义(P＜0.05).十二指肠乳头癌和壶腹癌的病灶突向十二指肠腔较胆总管下段癌更常见;而病灶大小、形态是否固定、增强水平、增强均匀性、胆管扩张程度、胰管是否扩张的差异均无统计学意义(P＞0.05).结论 DCUS是显示壶腹部癌的有效方法,有助于壶腹部癌的诊断,并有助于区分壶腹部癌中三种不同类型的癌.
목적 분석평개호복부암적쌍중대비초성조영(DCUS)효과,제고초성대해병적진단개치.방법 회고성분석40례경병리증실호복부암환자적DCUS급림상자료.결과 (1)DCUS대병조현시솔화대병조위치적판정준학성명현고우보통초성(P＜0.05).(2)호복부암적DCUS표현:제일례미발현병조외,병조다소우30 mm;100％(39/39)병조형태균고정;64.1％ (25/39)표현동맥기고혹등증강,정맥기저증강;87.2％ (34/39)증강균균;95％ (38/40)담관중중도확장.삼충불동류형암병조적위치、시부돌향십이지장강적차이유통계학의의(P＜0.05).십이지장유두암화호복암적병조돌향십이지장강교담총관하단암경상견;이병조대소、형태시부고정、증강수평、증강균균성、담관확장정도、이관시부확장적차이균무통계학의의(P＞0.05).결론 DCUS시현시호복부암적유효방법,유조우호복부암적진단,병유조우구분호복부암중삼충불동류형적암.
Objective To analyze the double contrast-enhanced ultrasonography (DCUS) features of periamupullary carcinoma for enhancing the ultrasound diagnostic value of the disease.Methods The DCUS and clinical data of 40 patients with periampullary carcinoma confirmed by histopathology were reviewed.Results (1) The displaying rate of the lesions and the judgment of lesion location was statistically higher on DCUS than that of ordinary ultrasound (P ＜ 0.05).(2) DCUS features of periampullary carcinoma:the size of most lesions was less than 30 mm except for 1 case in which no lesion was found; In 100％ (39/39) of the lesions,the morphology did not change with duodenum movement ; In 64.1％ (25/39) of lesions hyperenhancement or isoenhancement was displayed in the arterial phase,with low enhancement in the venous phase; In 87.2％ (34/39) of lesions homogeneous enhancement was displayed; In 95％ (38/40) the bile ducts were moderately or severely dilated.The lesion locations and whether the lesions projected into the duodenal cavity or not were statistically different between the three different types of periampullary carcinoma (P ＜ 0.05).The lesions projected into the duodenal cavity of duodenum were more commonly seen in papillary carcinoma and ampullary carcinoma than distal common bile duct carcinoma.The lesion size,whether the lesion morphology changed or not with duodenum movement,enhancement level,enhancement homogeneity,the degree of bile duct dilatation,whether there was pancreatic duct dilatation or not were not statistically different between the three different types of periampullay carcinoma (P ＞ 0.05).Conclusions DCUS is an effective way to show periampullay carcinoma,and is helpful to diagnose periampullary carcinoma and distinguish the three different types of periampullary carcinoma.