外科理论与实践

外科理论与实践 ›› 2020, Vol. 25 ›› Issue (04): 322-325.doi: 10.16139/j.1007-9610.2020.04.011

• 论著 • 上一篇    下一篇

声造影对胆囊癌与黄色肉芽肿性胆囊炎的鉴别诊断价值

张道建1,2, 张德祥3, 王吉文1, 陆品相3, 刘厚宝1(), 刘寒1()   

  1. 1.复旦大学附属中山医院普外科,上海 200032
    2.厦门市海沧医院普外二科,福建 厦门 361026
    3.复旦大学附属中山医院徐汇医院普外科,上海 200031
  • 收稿日期:2019-11-21 出版日期:2020-07-25 发布日期:2022-07-18
  • 通讯作者: 刘厚宝,刘寒 E-mail:liu.houbao@zs-hospital.sh.cn;liu.han@zs-hospital.sh.cn
  • 基金资助:
    上海市科学技术委员会项目(16411952000);徐汇区尖峰项目(SHXH201703)

Contrast-enhanced ultrasound in differential diagnosis of gallbladder cancer from xanthogranulomatous cholecystitis

ZHANG Daojian1,2, ZHANG Dexiang3, WANG Jiwen1, LU Pinxiang3, LIU Houbao1(), LIU Han1()   

  1. 1. Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
    2. Second Department of General Surgery, Xiamen Haichang Hospital, Fujian Xiamen 361026, China
    3. Department of General Surgery, Zhongshan-Xuhui Hospital, Fudan University, Shanghai 200031, China
  • Received:2019-11-21 Online:2020-07-25 Published:2022-07-18
  • Contact: LIU Houbao,LIU Han E-mail:liu.houbao@zs-hospital.sh.cn;liu.han@zs-hospital.sh.cn

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摘要：

目的：研究超声造影检查在胆囊癌与黄色肉芽肿性胆囊炎鉴别诊断中的应用。方法：回顾性分析复旦大学附属中山医院普外科2016年至2018年间病理检查诊断为胆囊癌和黄色肉芽肿性胆囊炎病人的常规超声与超声造影检查结果,比较两种检查鉴别两种胆囊疾病的准确性。结果：本研究81例病人中,39例术后病理检查为胆囊癌,42例为黄色肉芽肿性胆囊炎。39例胆囊癌病人中,31例接受胆囊根治术,8例接受姑息胆囊切除术。所有病人术前均于本院接受常规超声和超声造影检查。超声造影诊断的准确率为76.5%（62/81）,显著高于常规超声检查53.1%（43/81）,P=0.002。39例胆囊癌,超声造影诊断的准确率为82.1%（32/39）,显著高于常规超声检查53.8%（21/39）,P=0.007。在对胆囊癌的诊断效能评价中,超声造影的灵敏度、阳性预测值和阴性预测值分别为82.1%、72.7%和81.1%,显著高于常规超声检查。黄色肉芽肿性胆囊炎病人均行胆囊切除术。结论：超声造影检查在胆囊癌的术前鉴别诊断中的准确性明显优于常规超声检查。

关键词: 胆囊癌, 黄色肉芽肿性胆囊炎, 超声造影, 术前诊断

Abstract:

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in the preoperative diagnosis of gallbladder cancer (GBC) and xanthogranulomatous cholecystitis (XGC). Methods Eighty-one patients with GBC and with XGC in Department of General Surgery Zhongshan Hospital during 2016 and 2018 were analyzed retrospectively for comparing the accuracy of imaging examination to diagnose GBC and XGC between transabdominal ultrasound(TAUS) and CEUS. Results Thirty-nine patients with GBC and 42 patients with XGC diagnosed by pathological examination postope-ratively were recruited in this study. Radical surgery was done in 31 cases with GBC and palliative resection of gallbladder for the rest. The patients underwent both TAUS and CEUS preoperatively. The accuracy of CEUS in the assessment of patients with gallbladder disease (62/81, 76.5%) was higher than that of TAUS (43/81, 53.1%) (P=0.002) significantly. The accuracy of CEUS in the diagnosis of GBC (32/39, 82.1%) was significantly higher than TAUS (21/39, 53.8%), P=0.007. CEUS had sensitivity of 82.1% and positive predictive value of 72.7% and negative predictive value of 81.1%, which were significantly higher than those of TAUS, respectively. All the patients with XGC had cholecystectomy. Conclusions CEUS is a more effective approach for GBC with a promising diagnostic value than TAUS.

Key words: Gallbladder cancer, Xanthogranulomatous cholecystitis, Contrast-enhanced ultrasound, Preoperative diagnosis

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