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目的观察肝外胆管癌的超声造影特点,探讨该技术对肝外胆管癌诊断及鉴别诊断的价值。方法对21例经手术病理或胆管造影证实的肝外胆管癌患者进行二维及彩色多普勒超声检查,并经静脉团注SonoVue造影剂,行超声造影检查,观察肿块强化开始时间、强化方式、持续时间等,同时采用爆破及造影剂捕捉功能,重复观察病灶内造影剂灌注及显示情况。结果注射造影剂后,肿块9~19s肿块开始显影,所有肿块均有强化,持续时间约10~20s。肿块强化开始时间晚于总胆管壁,消退早于后者。21例患者中有5例伴有结石,5例侵犯周围肝组织,二维超声均难以判断。超声造影可以准确鉴别肿块和结石,并且能够判断肿块的侵犯范围,与手术病理结果一致。结论超声造影能实时观察肝外胆管肿块的微血流灌注情况,对肝外胆管癌的定性诊断及与胆管结石的鉴别诊断有较高的临床应用价值。
Objective To observe the characteristics of extrahepatic cholangiocarcinoma (CEUS) and evaluate the value of this technique in the diagnosis and differential diagnosis of extrahepatic cholangiocarcinoma. Methods Twenty-one patients with extrahepatic cholangiocarcinoma confirmed by pathology or cholangiography were examined by two-dimensional and color Doppler ultrasonography. SonoVue contrast agent was injected intravenously. Contrast-enhanced ultrasonography was performed to observe the onset of enhancement and the intensity of the enhancement , Duration, etc., while using blasting and contrast agent capture function, repeated observation of lesions within the contrast agent perfusion and display. Results After injection of contrast agent, the lumps of 9 ~ 19s started to develop, all the lumps were strengthened, the duration of about 10 ~ 20s. Mass enhancement started later than the total bile duct wall, dissipated earlier than the latter. Five of the 21 patients had calculi, and 5 had violations of the surrounding liver tissue. Two-dimensional sonography was difficult to determine. Contrast ultrasound can accurately identify lumps and stones, and can determine the scope of mass violations, consistent with the surgical pathology. Conclusion Contrast-enhanced ultrasound can observe the micro-perfusion of extrahepatic bile duct masses in real time, which has a high clinical value for the qualitative diagnosis of extrahepatic cholangiocarcinoma and differential diagnosis of bile duct stones.