本文選題：膽囊息肉樣病變　切入點(diǎn)：超聲造影　出處：《天津醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:比較各種類型膽囊息肉樣病變在超聲造影中體現(xiàn)出的不同血流灌注時(shí)間特點(diǎn)并進(jìn)行定量分析,初步探索超聲造影在膽囊息肉樣病變中的應(yīng)用價(jià)值。方法:選取我中心2014年9月至2017年3月共40例膽囊息肉樣病變患者作為研究對(duì)象,其中男性患者13例,女性患者27例,根據(jù)病理結(jié)果分為良性組與惡性組,良性組共33例包括膽固醇息肉19例、膽囊腺肌癥7例、慢性膽囊炎4例以及膽囊腺瘤3例,惡性組包括膽囊癌7例。由高年資超聲醫(yī)師回顧超聲造影影像資料,采用聲學(xué)定量分析軟件分析病灶的二維超聲和超聲造影血液灌注數(shù)據(jù),包括二維超聲的指標(biāo):1、大小2、數(shù)目3、回聲性質(zhì)4、膽囊壁完整性5、血流信號(hào);超聲造影的指標(biāo):1、開始增強(qiáng)時(shí)間2、達(dá)峰時(shí)間3、開始消退時(shí)間4、增強(qiáng)分布5、增強(qiáng)程度6、膽囊壁完整性7、血流形態(tài)。將各組患者的數(shù)據(jù)整理后運(yùn)用統(tǒng)計(jì)學(xué)軟件分析比較各型膽囊息肉在超聲造影中的差異,從而鑒別各型膽囊息肉。結(jié)果:良性組與惡性組比較:1、開始增強(qiáng)時(shí)間分別為19.76±0.67(s)與15.00±1.45(s)2、達(dá)峰時(shí)間分別為30.79±1.06(s)與23.57±1.57(s)3、開始消退時(shí)間分別為51.42±1.77(s)與30.14±1.71(s)4、良性組分布均勻者26例不均勻者7例,惡性組分布均勻者2例不均勻者5例5、良性組非高增強(qiáng)者29例高增強(qiáng)者4例,惡性組非高增強(qiáng)者3例高增強(qiáng)者4例6、良性組膽囊壁完整者29例中斷者4例,惡性組膽囊壁完整者1例中斷者6例7、良性組點(diǎn)狀血流者29例非點(diǎn)狀血流者4例,惡性組點(diǎn)狀血流者2例非點(diǎn)狀血流者5例。以上7組均有統(tǒng)計(jì)學(xué)差異(P0.05)膽固醇息肉與膽囊腺瘤比較:1、開始增強(qiáng)時(shí)間分別為19.84±0.64(s)與15.67±4.06(s)2、達(dá)峰時(shí)間分別為31.26±1.08(s)與22.33±5.21(s)3、開始消退時(shí)間分別為48.53±1.42(s)與41.00±1.00(s)4、膽固醇息肉組分布均勻者16例不均勻者3例,膽囊腺瘤組分布均勻者3例不均勻者0例5、膽固醇息肉組非高增強(qiáng)者16例高增強(qiáng)者3例,膽囊腺瘤組非高增強(qiáng)者2例高增強(qiáng)者1例6、膽固醇息肉組膽囊壁完整者16例中斷者3例,膽囊腺瘤組膽囊壁完整者3例中斷者0例7、膽固醇息肉組點(diǎn)狀血流者15例非點(diǎn)狀血流者4例,膽囊腺瘤組點(diǎn)狀血流者3例非點(diǎn)狀血流者0例。以上結(jié)果2、3組有統(tǒng)計(jì)學(xué)差異(P0.05)膽囊腺肌癥與膽囊癌比較:1、開始增強(qiáng)時(shí)間分別為19.29±1.30(s)與15.00±1.45(s)2、達(dá)峰時(shí)間分別為30.57±2.38(s)與23.57±1.57(s)3、開始消退時(shí)間分別為63.57±5.05(s)與30.14±1.71(s);4、膽囊腺肌癥組分布均勻者3例不均勻者4例,膽囊癌組分布均勻者2例不均勻者5例5、膽囊腺肌癥組非高增強(qiáng)者7例高增強(qiáng)者0例,膽囊癌組非高增強(qiáng)者3例高增強(qiáng)者4例6、膽囊腺肌癥組膽囊壁完整者6例中斷者1例,膽囊癌組膽囊壁完整者1例中斷者6例7、膽囊腺肌癥組點(diǎn)狀血流者7例非點(diǎn)狀血流者0例,膽囊癌組點(diǎn)狀血流者2例非點(diǎn)狀血流者5例。以上結(jié)果1、2、3、6、7組有統(tǒng)計(jì)學(xué)差異(P0.05)結(jié)論:1、惡性膽囊息肉的病灶開始增強(qiáng)時(shí)間、達(dá)峰時(shí)間、開始消退時(shí)間均早于良性膽囊息肉,惡性膽囊息肉多表現(xiàn)為分布不均勻、高增強(qiáng)、膽囊壁中斷以及非點(diǎn)狀血流,良性膽囊息肉多表現(xiàn)為分布均勻、非高增強(qiáng)、膽囊壁完整以及點(diǎn)狀血流。2、膽囊腺瘤的病灶達(dá)峰時(shí)間、開始消退時(shí)間均早于膽固醇息肉,增強(qiáng)分布、增強(qiáng)程度、膽囊壁完整性以及病灶內(nèi)部血流形態(tài)4項(xiàng)定性鑒別指標(biāo)在膽囊腺瘤與膽固醇息肉的對(duì)比中無明顯差異。3、膽囊癌的病灶開始增強(qiáng)時(shí)間、達(dá)峰時(shí)間、開始消退時(shí)間均早于膽囊腺肌癥,膽囊癌多表現(xiàn)為膽囊壁中斷以及非點(diǎn)狀血流,膽囊腺肌癥多表現(xiàn)為膽囊壁完整以及點(diǎn)狀血流。
[Abstract]:Objective: To compare the different types of blood perfusion characteristics of polypoid lesions of gallbladder reflected in contrast-enhanced ultrasonography and quantitative analysis, to explore the application value of contrast-enhanced ultrasound in diagnosis of gallbladder polypoid lesions. Methods: from September 2014 to March 2017 a total of 40 cases of central polypoid lesions of the gallbladder patients as the research object, including 13 cases of male patients, 27 female patients, according to the pathological results were divided into benign group and malignant group and benign group were 33 cases including 19 cases of cholesterol polyp, 7 cases of gallbladder adenomyosis, 3 cases of chronic cholecystitis and 4 cases of gallbladder adenoma, malignant group including 7 cases of gallbladder carcinoma. With high seniority ultrasound doctors review ultrasound contrast imaging data, using acoustic quantitative analysis software were analyzed with two-dimensional ultrasound and contrast-enhanced ultrasound perfusion data, including 2D ultrasound index: 1, size 2, number 3, echo property 4, gallbladder wall integrity 5, blood 嫻佷俊鍙，

本文編號(hào)：1709709