Ultrasonic differential diagnosis of infant congenital cystic mass in the hepatic hilar
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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。 -
关键词:
- 超声 /
- 先天性囊肿型胆道闭锁 /
- 胆总管囊肿
Abstract:Objective To investigate the value of ultrasound in the diagnosis of infant congenital cystic biliary atresia and choledochal cyst. Methods 31 children with cystic mass in the hepatic hilar admitted to our hospital from June 2016 to June 2017 were randomly selected, all of which received ultrasound examination and operation. Subjects were divided into cystic biliary atresia group (n=15) and choledochal cyst group (n=16) according to the surgical results. Factors including intrahepatic bile duct dilatation, fibrotic tissue around porta hepatis, the incidence of biliary sludge in the gallbladder, deformed gallbladder, contractile dysfunction of gallbladder, the inside diameter of hepatic artery, gallbladder size and cyst volume were statistically analyzed. Results The incidences of intrahepatic bile duct dilatation and gallbladder biliary sludge in the cystic biliary atresia group (0%; 6.7%, 1/15) were significantly lower than those in the choledochal cyst group (75.0%, 12/16; 50.0%, 8/16)(P<0.05); the incidences of fibrotic tissue around porta hepatis, deformed gallbladder and contractile dysfunction of gallbladder in the cystic biliary atresia group (80.0%,12/15; 86.7%, 13/15; 73.3%, 11/15)were significantly higher than that of the control group (0%; 6.3%,1/16; 12.5%, 2/16) (P<0.05). In the choledochal cyst group, the inside diameter of the hepatic artery was significantly longer than that of the common bile duct cyst (P<0.05), but there was no significant difference in the length of the gallbladder(P>0.05). Conclusion The application of ultrasound in the identification of congenital cystic biliary atresia and choledochal cyst has high value. -
Key words:
- ultrasound /
- congenital cyst type biliary atresia /
- choledochal cyst
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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) 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 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 -
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