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婴儿先天性肝门部囊性占位的超声鉴别

张遇乐 王娜 关步云 陈金卫

张遇乐, 王娜, 关步云, 陈金卫. 婴儿先天性肝门部囊性占位的超声鉴别[J]. 分子影像学杂志, 2018, 41(2): 147-151. doi: 10.3969/j.issn.1674-4500.2018.02.03
引用本文: 张遇乐, 王娜, 关步云, 陈金卫. 婴儿先天性肝门部囊性占位的超声鉴别[J]. 分子影像学杂志, 2018, 41(2): 147-151. doi: 10.3969/j.issn.1674-4500.2018.02.03
Yule ZHANG, Na WANG, Buyun GUAN, Jinwei CHEN. Ultrasonic differential diagnosis of infant congenital cystic mass in the hepatic hilar[J]. Journal of Molecular Imaging, 2018, 41(2): 147-151. doi: 10.3969/j.issn.1674-4500.2018.02.03
Citation: Yule ZHANG, Na WANG, Buyun GUAN, Jinwei CHEN. Ultrasonic differential diagnosis of infant congenital cystic mass in the hepatic hilar[J]. Journal of Molecular Imaging, 2018, 41(2): 147-151. doi: 10.3969/j.issn.1674-4500.2018.02.03

婴儿先天性肝门部囊性占位的超声鉴别

doi: 10.3969/j.issn.1674-4500.2018.02.03
详细信息
    作者简介:

    张遇乐,副主任医师,E-mail: octopus883@163.com

    通讯作者:

    王 娜,副主任医师,E-mail: 423352651@qq.com

Ultrasonic differential diagnosis of infant congenital cystic mass in the hepatic hilar

  • 摘要: 目的 探讨超声用于鉴别先天性囊肿型胆道闭锁和胆总管囊肿的应用价值。 方法 随机选取2016年6月~2017年6月我院收治的肝门区囊肿患儿31例,所有患儿均接受超声检查及手术治疗,依据手术结果将这些患儿分为囊肿型胆道闭锁组(n=15)和胆总管囊肿组(n=16),对两组患儿的肝内胆管扩张、肝门部纤维块、胆囊内胆泥沉积、胆囊形态异常、胆囊收缩不良发生情况、肝动脉内径、胆囊大小、囊肿体积进行统计分析。 结果 囊肿型胆道闭锁组患儿的肝内胆管扩张、胆囊内胆泥沉积发生率0%、6.7%(1/15)均显著低于胆总管囊肿组75.0%(12/16)、50.0%(8/16)(P<0.05),肝门部纤维块、胆囊形态异常、胆囊收缩不良发生率80.0%(12/15)、86.7%(13/15)、73.3%(11/15)均显著高于胆总管囊肿组0%、6.3%(1/16)、12.5%(2/16)(P<0.05),肝动脉内径长于胆总管囊肿组(P<0.05),囊肿体积小于胆总管囊肿组(P<0.05),胆囊宽径短于胆总管囊肿组(P<0.05),但两组患儿的胆囊长径之间的差异无统计学意义(P>0.05)。 结论 超声用于鉴别先天性囊肿型胆道闭锁和胆总管囊肿的应用价值高。

     

  • 图  1  囊肿型胆道闭锁(A)及胆总管囊肿(B)超声声像图

    图  2  胆囊内胆泥沉积

    图  3  肝门部纤维块

    图  4  胆囊形态异常

    表  1  两组患儿的一般资料比较[n(%)]

    项目 囊肿型胆道闭锁组(n=15) 胆总管囊肿组(n=16) t/χ2 P
    性别
      男性 10(66.7) 12(75.0) 1.32 >0.05
      女性 5(33.3) 4(25.0)
    年龄(d) 35.2±5.4 44.5±10.2 1.886 >0.05
    胆红素(μmol/L) 182.2±32.5 192.8±32.4 1.638 >0.05
    直接胆红素(μmol/L) 135.2±23.9 145.6±23.2 1.533 >0.05
    手术类型
      肝门空肠吻合术/胆总管囊肿、胆囊切除+肝总管-空肠Roux-en-Y吻合术 14(93.3) 16(100.0)
      肝移植术/其他 1(6.7) 0(0)
    下载: 导出CSV

    表  2  两组患儿的肝内胆管扩张、肝门部纤维块、胆囊内胆泥沉积、胆囊形态异常、胆囊收缩不良发生情况比较[n(%)]

    组别 肝内胆管扩张 肝门部 纤维块 胆囊内胆泥沉积 胆囊形态 异常 胆囊收缩不良
    囊肿型胆道闭锁组 0(0) 12(80.0) 1(6.7) 13(86.7) 11(73.3)
    胆总管囊肿组 12(75.0) 0(0) 8(50.0) 1(6.3) 2(12.5)
    χ2 5.02 5.02 7.38 11.14 9.35
    P <0.05 <0.05 <0.05 <0.05 <0.05
    下载: 导出CSV

    表  3  两组患儿的肝动脉内径、胆囊大小、囊肿体积比较(Mean±SD)

    组别 肝动脉内径(mm) 胆囊大小(cm) 囊肿体积(cm3
    长径 宽径
    囊肿型胆道闭锁组 2.3±0.3 28.3±4.5 5.3±1.5 2.6±0.3
    胆总管囊肿组 1.7±0.2 27.3±4.2 8.3±2.3 56.1±10.8
    t 2.776 1.476 3.182 4.303
    P <0.05 >0.05 <0.05 <0.05
    下载: 导出CSV
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  • 收稿日期:  2018-01-12
  • 刊出日期:  2018-04-01

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