胆囊息肉样病变的CT增强及超声表现与病理结果的对照分析(1)
【摘要】 目的：探讨CT增强及超声检查在诊断胆囊息肉样病变和鉴别其良恶性中的应用价值。方法：收集35例经手术病理证实为胆囊息肉样病变患者的影像资料(包括CT增强及超声)并与病理结果进行對比。结果：35例胆囊息肉样病变，良性28例，恶性7例。在28例良性病变中，CT增强诊断出20例，定性准确率为71.4%；超声诊断出25例，定性准确率为89.3%。在7例恶性病变中，CT增强诊断出6例，定性准确率为85.7%；超声诊断出5例，定性准确率为71.4%。结论：CT增强和超声均能较好地诊断胆囊息肉样病变。CT增强在鉴别病变的良恶性上优于超声，而超声对良性病变病理分型的诊断价值更高。
【关键词】 胆囊息肉样病变； CT； 超声
Comparative Analysis on CT Enhancement and Ultrasonography Findings of Polypoid Lesions of Gallbladder with Pathology/ZHU Congcong，YANG Qing.//Medical Innovation of China，2018，15(03)：107-110
, 百拇医药
【Abstract】 Objective：To evaluate the application value of CT enhancement and ultrasound examination in diagnosis polypoid lesions of gallbladder and differential diagnosis of benign and malignant of them.Method：The imaging data of 35 patients with pathologically proved polypoid lesions of the gallbladder(including CT enhancement and ultrasound)were collected and compared with pathological findings.Result：Among 35 cases of polypoid lesions of gallbladder，28 cases were benign，and 7 cases were malignant.20 cases of the 28 benign lesions of gallbladder were diagnosed by CT enhancement，with qualitative accuracy of 71.4%； 25 cases of the 28 benign lesions of gallbladder were diagnosed by ultrasound，with qualitative accuracy of 89.3%.6 cases of the 7 malignant lesions were diagnosed by CT enhancement，with accuracy of 85.7%；5 cases of the 7 malignant lesions were diagnosed by ultrasound，with accuracy of 71.4%.Conclusion：CT enhancement scan and ultrasound examination were both effective in diagnosing polypoid lesions of gallbladder.CT enhancement is superior to ultrasound in differential diagnose of benign and malignant lesions，however，ultrasound was proved to have higher diagnostic value of pathological type of benign lesions.
, 百拇医药
【Key words】 Polypoid lesions of gallbladder； CT； Ultrasound
First-author’s address：Affiliated Hospital of Qingdao University，Qingdao 266061，China
doi：10.3969/j.issn.1674-4985.2018.03.029
胆囊息肉样病变(polypoid lesions of gallbladder，PLG)是一种形态学上的命名方式，泛指一类源于胆囊壁呈息肉状突向胆囊腔内的非结石性病变的总称[1-2]。在病理学上，胆囊息肉样病变分为非肿瘤性(如胆固醇性息肉、炎性息肉、增生性息肉等)和肿瘤性(如腺瘤和腺癌等)[3]。近年来，随着超声体检的广泛应用，筛检出的PLG较以往明显增多，超声报道其检出率为3.0%～7.0%[4]。在鉴定PLG良恶性及评估恶性潜能方面，常通过超声进行随访，观察病变外观及内部血流信号的变化情况，但效果不甚理想。而恶性PLG如胆囊癌，其临床症状往往较轻，发现时大部分已属晚期，预后极差[5]。故早期明确PLG的良恶性，对患者及时有效地接受治疗至关重要。本文拟分析经病理证实的35例PLG的CT增强及超声表现特点，探讨两种影像学检查方法的诊断价值，为临床早期诊断与治疗提供帮助。
1 资料与方法
1.1 一般资料 收集本院2014年1月-2017年1月共35例胆囊息肉样病变患者的影像资料(包括CT增强及超声)及临床资料。纳入标准：(1)影像及临床资料齐全；(2)经手术病理证实；(3)影像学检查与手术时间间隔在一个月内。排除标准：(1)良恶性胆囊息肉样病变混合存在；(2)病变长径>25 mm；(3)CT增强或超声诊断结果不明确的病例。其中，男16例，女19例，年龄25～70岁，平均(51.3±2.5)岁。35例患者中，有24例为查体发现，10例表现为上腹部疼痛不适等，1例表现为全身皮肤黄染。所有患者均对该研究知情同意。, http://www.100md.com(朱聪聪 杨青)
【关键词】 胆囊息肉样病变； CT； 超声
Comparative Analysis on CT Enhancement and Ultrasonography Findings of Polypoid Lesions of Gallbladder with Pathology/ZHU Congcong，YANG Qing.//Medical Innovation of China，2018，15(03)：107-110
, 百拇医药
【Abstract】 Objective：To evaluate the application value of CT enhancement and ultrasound examination in diagnosis polypoid lesions of gallbladder and differential diagnosis of benign and malignant of them.Method：The imaging data of 35 patients with pathologically proved polypoid lesions of the gallbladder(including CT enhancement and ultrasound)were collected and compared with pathological findings.Result：Among 35 cases of polypoid lesions of gallbladder，28 cases were benign，and 7 cases were malignant.20 cases of the 28 benign lesions of gallbladder were diagnosed by CT enhancement，with qualitative accuracy of 71.4%； 25 cases of the 28 benign lesions of gallbladder were diagnosed by ultrasound，with qualitative accuracy of 89.3%.6 cases of the 7 malignant lesions were diagnosed by CT enhancement，with accuracy of 85.7%；5 cases of the 7 malignant lesions were diagnosed by ultrasound，with accuracy of 71.4%.Conclusion：CT enhancement scan and ultrasound examination were both effective in diagnosing polypoid lesions of gallbladder.CT enhancement is superior to ultrasound in differential diagnose of benign and malignant lesions，however，ultrasound was proved to have higher diagnostic value of pathological type of benign lesions.
, 百拇医药
【Key words】 Polypoid lesions of gallbladder； CT； Ultrasound
First-author’s address：Affiliated Hospital of Qingdao University，Qingdao 266061，China
doi：10.3969/j.issn.1674-4985.2018.03.029
胆囊息肉样病变(polypoid lesions of gallbladder，PLG)是一种形态学上的命名方式，泛指一类源于胆囊壁呈息肉状突向胆囊腔内的非结石性病变的总称[1-2]。在病理学上，胆囊息肉样病变分为非肿瘤性(如胆固醇性息肉、炎性息肉、增生性息肉等)和肿瘤性(如腺瘤和腺癌等)[3]。近年来，随着超声体检的广泛应用，筛检出的PLG较以往明显增多，超声报道其检出率为3.0%～7.0%[4]。在鉴定PLG良恶性及评估恶性潜能方面，常通过超声进行随访，观察病变外观及内部血流信号的变化情况，但效果不甚理想。而恶性PLG如胆囊癌，其临床症状往往较轻，发现时大部分已属晚期，预后极差[5]。故早期明确PLG的良恶性，对患者及时有效地接受治疗至关重要。本文拟分析经病理证实的35例PLG的CT增强及超声表现特点，探讨两种影像学检查方法的诊断价值，为临床早期诊断与治疗提供帮助。
1 资料与方法
1.1 一般资料 收集本院2014年1月-2017年1月共35例胆囊息肉样病变患者的影像资料(包括CT增强及超声)及临床资料。纳入标准：(1)影像及临床资料齐全；(2)经手术病理证实；(3)影像学检查与手术时间间隔在一个月内。排除标准：(1)良恶性胆囊息肉样病变混合存在；(2)病变长径>25 mm；(3)CT增强或超声诊断结果不明确的病例。其中，男16例，女19例，年龄25～70岁，平均(51.3±2.5)岁。35例患者中，有24例为查体发现，10例表现为上腹部疼痛不适等，1例表现为全身皮肤黄染。所有患者均对该研究知情同意。, http://www.100md.com(朱聪聪 杨青)