肝胆管结石病的彩超诊断及鉴别诊断研究

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摘要    [摘要 ] 目的 探究肝胆管结石病的彩超诊断价值及鉴别诊断分析。方法 对 2018年 2月— 2020年 2月期间该院收治的 52例肝胆管结石患者行彩超诊断的临床资料进行回顾性分析。结果 52例患者肝胆管结石大小为 0.3~ 3.2 cm,以位于肝左叶居多,占 67.3%( 35/52),与肝右叶分布率及左右肝内胆管结石分布率比较,结石分布差异有统计学意义, χ2分别为 18.73和 39.43, P<0.05。其声像图表现为沿左右肝内胆管走行呈簇状分布,可见多发泥沙样结石呈斑点状、条索状、团块状或不规则分布的高、强回声,后方大多伴明显声影,近端肝内胆管扩张至 0.5~ 2.1 cm,与伴行的门静脉分支形成“平行管征”。病灶部位血流显像中可见,门静脉及肝动脉血流显像均清晰者 46例(占 88.5%)。结论 彩超检查是肝胆管结石病重要的诊断手段,在超声下多角度、多切面扫查,并利用门静脉血流动力学信息,可准确判断及鉴别。     [关键词 ] 肝胆管结石病;彩超;诊断;鉴别诊断    [Abstract] Objective To explore the value of color Doppler ultrasonography in the diagnosis and differential diagnosis of hepatolithiasis. Methods the clinical data of 52 patients with hepatolithiasis diagnosed by color Doppler ultrasound from February 2018 to February 2020 were analyzed retrospectively. Results the size of hepatolithiasis in 52 patients was 0.3-3.2cm, most of them were located in the left lobe of the liver, accounting for 67.3% (35 / 52). Compared with the distribution of hepatolithiasis in the right lobe of the liver and in the left and right lobes of the liver, the difference in the distribution of stones was statistically significant, χ 2 was 18.73 and 39.43, respectively, P < 0.05. The sonogram showed that the stones were distributed in clusters along the left and right intrahepatic bile ducts, and the multiple sediment like stones were highly and strongly echoed in spots, cords, lumps or irregular distribution. Most of the stones were accompanied by obvious acoustic shadow at the rear. The proximal intrahepatic bile duct expanded to 0.5-2.1 cm, forming "parallel duct sign" with the accompanying portal vein branches. 46 cases (88.5%) had clear blood flow imaging of portal vein and hepatic artery. Conclusion color Doppler ultrasound is an important diagnostic method for hepatolithiasis. It can be used for accurate diagnosis and differentiation by multi angle and multi section scanning under ultrasound and using portal vein hemodynamic information.
出处 《世界复合医学》 2020年3期
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出版日期 2020年04月28日(中国期刊网平台首次上网日期,不代表论文的发表时间)
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