| 张艳玲,许尔蛟,郑荣琴,任杰,苏中振.经皮二维胆道超声造影的临床应用[J].中国医学影像技术,2011,27(6):1205~1208 |
| 经皮二维胆道超声造影的临床应用 |
| Clinical application of two-dimensional contrast-enhanced ultrasonic cholangiography |
| 投稿时间：2010-11-23 修订日期：2010-12-31 |
| DOI： |
| 中文关键词: 超声检查 造影剂 胆道 黄疸,阻塞性 |
| 英文关键词:Ultrasonography Contrast media Bile ducts Jaundice, obstructive |
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| 中文摘要: |
| 目的 探讨经皮二维胆道超声造影(2D-CEUSC)评价胆道梗阻性疾病的临床价值。方法 对33例因胆道梗阻性病变接受T管(21例)或PTC管(12例)插管的患者进行2D-CEUSC检查,以X线胆道造影(CC)作为金标准,分别评估图像质量、显示肝内胆管的最高级别及对梗阻性病变(包括有无梗阻、梗阻水平、梗阻程度及梗阻原因)的判断。结果 全部33例2D-CEUSC均清晰显示肝内外胆管直至梗阻段,图像质量评分均为优或中,可满足诊断需要,但与CC的差异有统计学意义(P=0.005);在显示胆管级别方面,2D-CEUSC可清晰显示(3.64±0.96)级肝内胆管,而CC为(3.79±0.74)级,差异无统计学意义(P=0.268)。治疗后仍存在胆道梗阻的22例中,2D-CEUSC对14例的梗阻水平、梗阻程度及梗阻原因判断正确,其中2D-CEUSC对肝门部梗阻、狭窄大于50％、完全梗阻及肿瘤性梗阻的判断与CC符合率分别为85.71%(6/7)、100%(3/3)、100%(9/9)和100%(12/12),对小病灶引起的不完全性梗阻正确判断的例数较低。结论 作为一种新的胆道造影方法,2D-CEUSC对肝内胆管分支的显示情况与CC接近,可作为术前评估胆道梗阻的有益补充。 |
| 英文摘要: |
| Objective To investigate the clinical value of two-dimensional contrast-enhanced ultrasonic cholangiography (2D-CEUSC) in obstructive biliary tract diseases. Methods 2D-CEUSC was performed in 33 patients who underwent PTC (twenty-one cases) or T-tube (twelve cases) because of obstructive biliary tract diseases. Image quality, the visualization of branching orders and the judgment of diseases (including whether be obstructive, the level, degree and reason of obstruction) were estimated. And the results were compared with that of conventional cholangiography (CC). Results Intra- and extrahepatic bile ducts until the obstructive segments were visualized clearly in all 33 2D-CEUSC. The image quality score were well or moderate which could satisfy the diagnostic requirement. However, there was statistically significant difference compared to CC (P=0.005). The maximum visualization of bile branches in 2D-CEUSC was (3.64±0.96), not significantly different with the results (3.79±0.74) of CC (P=0.268). Thirteen of twenty-two patients with obstruction in different level and degree were detected with 2D-CEUSC. The coincidence rate of obstruction in porta hepatic, exceed 50％ or complete, and tumorous obstruction was 85.71% (6/7), 100% (3/3), 100% (9/9) and 100% (12/12), respectively. The accurate judged amount of incomplete obstruction due to small lesions was low. Conclusion As a new method for cholangiography, 2D-CEUSC is close to CC in displaying the intrahepatic biliary branches and determining the obstructive biliary tract diseases. It can be used as supplement in evaluating the biliary obstruction preoperation. |
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