Please wait a minute...
浙江大学学报（医学版）
浙江大学学报（医学版）  2017, Vol. 46 Issue (5): 552-556    DOI: 10.3785/j.issn.1008-9292.2017.10.16
原著     
超声检查对黄色肉芽肿性胆囊炎的诊断价值
刘春媚, 黄品同, 王尧, 张旭, 游向东
浙江大学医学院附属第二医院超声科, 浙江 杭州 310009
Value of ultrasonography in diagnosis of xanthogranulomatous cholecystitis
LIU Chunmei, HUANG Pintong, WANG Yao, ZHANG Xu, YOU Xiangdong
Department of Ultrasonography, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
 全文: PDF(962 KB)  
摘要：

目的：通过比较黄色肉芽肿性胆囊炎（XGC）和厚壁型胆囊癌的超声征象，评估超声检查对XGC的诊断价值。方法：回顾性分析经病理学检查诊断的31例XGC和36例厚壁型胆囊癌患者的临床表现和超声图像资料，收集胆囊壁厚度、胆囊壁厚的范围、胆囊壁内有无低回声结节、胆囊黏膜线是否连续、胆囊或胆管内有无结石、胆道有无扩张及胆囊-肝脏分界是否清晰等超声征象并进行对照分析。结果：XGC组胆囊壁内低回声结节、胆囊内壁黏膜线连续以及胆道扩张与厚壁型胆囊癌组比较差异均有统计学意义（均P<0.05），而其余超声征象在两组间差异无统计学意义（均P>0.05）。其中，胆囊壁内低回声结节和胆囊内壁黏膜线连续诊断XGC具有较高的准确度，分别为64.2%和65.7%。结论：增厚的胆囊壁内低回声结节、胆囊壁内黏膜线连续是XGC较具特征性的超声表现。
关键词： 胆囊炎/超声检查;  黄瘤病/超声检查;  超声检查;  肉芽肿/超声检查;  回顾性研究;  多普勒;  彩色    
Abstract:

Objective: To assess the value of ultrasonography in differential diagnosis of xanthogranulomatous cholecystitis (XGC) and wall-thickening type of gallbladder cancer (GBC).Methods: The clinical features and sonographic finding of 31 patients with XGC and 36 patients with wall-thickening type of GBC were retrospectively reviewed. The diagnosis of all cases was confirmed by pathological examination, and the ultrasonographic manifestations of the thickening of the gallbladder wall, intramural hypoechoic nodules, gallbladder mucosa line, gallbladder stones, biliary dilatation and gallbladder-liver boundary were compared between two groups.Results: There were significant differences in the intramural hypoechoic nodules, the continuous gallbladder wall mucosal line and dilatation of bile duct between XGC and GBC groups (all P<0.05), while no statistically significant differences in the other sonographic features(all P>0.05). In the six positive sonographic features of the XGC patients, the intramural hypoechoic nodules and the continuous mucosa line of the gallbladder wall had highest accuracy in the diagnosis of XGC(64.2% and 65.7%).Conclusion: Intramural hypoechoic nodule and the continuous mucosal line are characteristic sonographic features of XGC, which can be used for the diagnosis of XGC.
Key words: Xanthomatosis/ultrasonography    Cholecystitis/ultrasonography    Granuloma/ultrasonography    Ultrasonography,doppler,color    Retrospective studies
收稿日期: 2017-04-28 出版日期: 2017-10-25
CLC:  R445.1  
基金资助:

浙江省自然科学基金（LY14H180003）
通讯作者: 游向东(1963-),男,博士,主任医师,硕士生导师,主要从事超声诊断、超声引导介入治疗及相关基础研究;E-mail:2190005@zju.edu.cn;http://orcid.org/0000-0002-7562-3929     E-mail: 2190005@zju.edu.cn
作者简介: 刘春媚(1983-),女,硕士研究生,主治医师,主要从事腹部超声诊断及相关研究;E-mail:lcm_springwater@163.com;http://orcid.org/0000-0001-7744-3107
服务　　
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章　　

引用本文:

刘春媚 等. 超声检查对黄色肉芽肿性胆囊炎的诊断价值[J]. 浙江大学学报（医学版）, 2017, 46(5): 552-556.

LIU Chunmei, HUANG Pintong, WANG Yao, ZHANG Xu, YOU Xiangdong. Value of ultrasonography in diagnosis of xanthogranulomatous cholecystitis. Journal of ZheJiang University(Medical Science), 2017, 46(5): 552-556.

链接本文:

http://www.zjujournals.com/xueshu/med/CN/10.3785/j.issn.1008-9292.2017.10.16    或    http://www.zjujournals.com/xueshu/med/CN/Y2017/V46/I5/552

[1] ZHANG L F, HOU C S, LIU J Y, et al. Strategies for diagnosis of xanthogranulomatous cholecystitis masquerading as gallbladder cancer[J]. Chin Med J (Engl),2012,125(1):109-113.
[2] AGARWAL A K, KALAYARASAN R, JAVED A, et al. Mass-forming xanthogranulomatous cholecystitis masquerading as gallbladder cancer[J]. J Gastrointest Surg,2013,17(7):1257-1264.
[3] 张梅,彭玉兰,罗燕,等.黄色肉芽肿性胆囊炎的超声表现及其病理学基础[J].世界华人消化杂志,2004,12(3):738-740. ZHANG Mei, PENG Yulan, LUO Yan, et al. Xanthogranulomatous cholecystitis:sonographic,surgical and pathologic correlation[J]. World Chinese Journal of Digestology,2004,12(3):738-740. (in Chinese)
[4] SPINELLI A, SCHUMACHER G, PASCHER A, et al. Extended surgical resection for xanthogranulomatous cholecystitis mimicking advanced gallbladder carcinoma:a case report and review of literature[J]. World J Gastroenterol,2006,12(14):2293-2296.
[5] RAJAGURU K, MEHROTRA S, LALWANI S, et al. New scoring system for differentiating xanthogranulomatous cholecystitis from gall bladder carcinoma:a tertiary care centre experience[J/OL]. ANZ J Surg,2016.
[6] YOSHIMITSU K, IRIE H, AIBE H, et al. Well-differentiated adenocarcinoma of the gallbladder with intratumoral cystic components due to abundantmucin production:a mimicker of adenomyomatosis[J]. European Radiology,2005,15(2):229-233.
[7] SHETTY G S, ABBEY P, PRABHU S M, et al. Xanthogranulomatous cholecystitis:sonographic and CT features and differentiation from gallbladder carcinoma:a pictorial essay[J]. Jpn J Radiol,2012,30(6):480-485.
[8] GOSHIMA S, CHANG S, WANG J H, et al. Xanthogranulomatous cholecystitis:diagnostic performance of CT to differentiate from gallbladder cancer[J]. Eur J Radiol,2010,74(3):e79-e83.
[9] PARRA J A, ACINAS O, BUENO J, et al. Xanthogranulomatous cholecystitis:clinical, sonographic, and CT findings in 26 patients[J]. AJR Am J Roentgenol,2000,174(4):979-983.
[10] DAO A H, WONG S W, ADKINS R B JR. Xanthogranulomatous cholecystitis. A clinical and pathologic study of twelve cases[J]. Am Surg,1989,55(1):32-35.
[11] LEVY A D, MURAKATA L A, ROHRMANN C A JR. Gallbladder carcinoma:radiologic-pathologic correlation[J]. Radiographics,2001,21(2):295-314.
[12] GUERMAZI A. Are there other imaging features to differentiate xanthogran-ulomatous cholecystitis from gallbladder carcinoma?[J]. Eur Radiol,2005,15(6):1271-1273.
[13] CHUN K A, HA H K, YU E S, et al. Xanthogranulomatous cholecystitis:CT features with emphasis on differentiation from gallbladder carcinoma[J]. Radiology,1997,203(1):93-97.
[14] UCHIYAMA K, OZAWA S, UENO M, et al. Xanthogranulomatous cholecystitis:the use of preoperative CT findings to differentiate it from gallbladder carcinoma[J]. J Hepatobiliary Pancreat Surg,2009,16(3):333-338.
[1] 李爱静 等. 动态增强磁共振成像参照物模型定量参数与乳腺癌预后因素及分子病理分型的关系[J]. 浙江大学学报（医学版）, 2017, 46(5): 505-510.
[2] 裴磊 等. 磁共振平扫T1加权像脑内核团高信号与钆对比剂注射次数的相关性[J]. 浙江大学学报（医学版）, 2017, 46(5): 487-491.
[3] 窦琳琳,杨国绘,莫伟明. 本地胎儿双顶径估算孕龄应用于孕中期产前筛查的意义[J]. 浙江大学学报（医学版）, 2017, 46(1): 59-65.
[4] 吴菡,王钟瑾,明文杰,王爽,丁美萍. 长程视频脑电图监测癫痫患者发作间期痫样放电的时段分析[J]. 浙江大学学报（医学版）, 2017, 46(1): 30-35.
[5] 夏光发 等. 新辅助化疗前后激素受体变化的乳腺癌患者辅助内分泌治疗的疗效[J]. 浙江大学学报（医学版）, 2016, 45(6): 614-619.
[6] 蒋倩倩 等. 高血压伴阻塞性睡眠呼吸暂停低通气综合征患者肾功能影响因素分析[J]. 浙江大学学报（医学版）, 2016, 45(3): 261-267.
[7] 陈小红 等. 88例嗜酸性粒细胞增多症住院患儿临床表现及病因分析[J]. 浙江大学学报（医学版）, 2016, 45(3): 292-296.
[8] 陈思腾 等. 肾移植受者与普通患者泌尿系统感染的比较[J]. 浙江大学学报（医学版）, 2016, 45(2): 201-207.
[9] 边薇 等. 临时血液透析对维持性腹膜透析患者生存预后的影响[J]. 浙江大学学报（医学版）, 2016, 45(2): 195-200.
[10] 宋瑞瑞等. 亚急性期缺血性卒中患者弥散加权成像高信号病灶的体素内不相干运动研究[J]. 浙江大学学报（医学版）, 2015, 44(6): 632-637,644.
[11] 秦冰, 应广宇, 胡华, 陈高, 张建民, 王林. 经眶上外侧入路夹闭颅内前循环动脉瘤的临床应用[J]. 浙江大学学报（医学版）, 2015, 44(4): 383-388.
[12] 郑跃英, 潘彩飞, 祝胜美. 脑血流自动调节监测及其围手术期应用研究进展[J]. 浙江大学学报（医学版）, 2015, 44(4): 451-457.
[13] 田吉顺, 潘飞霞, 何赛男, 胡文胜. 瘢痕子宫合并前置胎盘孕妇孕中晚期引产的危险因素分析[J]. 浙江大学学报（医学版）, 2015, 44(3): 247-252.
[14] 刘益枫, 叶晓群, 朱琳玲, 黄贇, 吴伊青, 徐鹏, 孔雨佳, 刘凤, 孙赛君, 张丹. 影响再生育继发不孕妇女体外受精—胚胎移植临床妊娠结局的多因素分析[J]. 浙江大学学报（医学版）, 2015, 44(3): 237-246.
[15] 朱长焜, 王斐, 周雨梅, 应俊, 陈丹青. 再生育孕妇合并凶险性前置胎盘的妊娠结局分析[J]. 浙江大学学报（医学版）, 2015, 44(3): 253-257.