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低频与高频超声联合诊断胆囊息肉样病变价值分析

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目的 探讨高频和低频超声联合检查诊断胆囊息肉样病变(PLG)的价值。方法 2020 年5 月~2023 年4月我院诊治的PLG患者64 例,术前均接受低频超声和高频超声检查,行腹腔镜下胆囊切除术,术中留取组织行病理学检查。以Kappa系数评价超声诊断与组织病理学检查诊断的一致性。结果 在64 例PLG患者中,经组织病理学检查诊断良性病变59 例和恶性病变 5 例;超声检查恶性病变单发、宽基底和发现有血流信号百分比分别为 80。0%、80。0%和80。0%,均显著高于良性病变的 44。1%、33。9%和 27。1%(P<0。05);经低频超声诊断恶性病变 9 例(14。1%)、良性病变55 例(85。9%),经高频超声诊断恶性病变8 例(12。5%)、良性病变56 例(87。5%),经高频/低频超声联合诊断恶性病变7例(10。9%)、良性病变57 例(89。1%),三种方法 诊断结果 比较差异无统计学意义(P>0。05);高频/低频超声联合诊断病变良恶性的敏感度、特异度和准确率分别为 100。0%、96。6%和 71。4%,与组织病理学诊断结果 的一致性较高(kappa= 0。817)。结论 鉴于高频与低频超声各有优缺点,两者联合诊断PLG病变性质可能能提高诊断的准确性,值得不断尝试。
High-frequency and low-frequency ultrasound in the diagnosis of polypoid lesions of gallbladder
Objective The aim of this study was to investigate the high-frequency and low-frequency ultrasound in the diagnosis of polypoid lesions of gallbladder(PLG).Methods 64 patients with PLG were enrolled in our hospital between May 2020 and April 2023,and they all underwent low-frequency and high-frequency ultrasonography and thereafter laparoscopic cholecystectomy(LC).The histo-pathological examination was routinely performed,and the diagnosis by ultrasonography was evaluated by Kappa coefficient.Results Among the 64 patients with PLG,the histopathological examination found benign lesions in 59 cases and malignant lesions in 5 cases;the ultrasonic features included the single lesion,wide substrate and lesions with blood signals in malignant lesions;the low-frequency ultrasound found malignant lesions in 9 cases(14.1)and benign lesions in 55 cases(85.9%),the high-frequency ultrasound found malignant lesions in 8 cases(12.5%)and benign lesions in 56 cases(87.5%)and the low-and high-frequency ultrasound combination diagnosed malignant lesions in 7 cases(10.9%)and benign lesions in 57 cases(89.1%),without significant differences among them(P>0.05);the sensitivity,specificity and accuracy by the high-frequency and low-frequency ultrasound combination in judging the quality of PLG were 100.0%,96.6%and 71.4%,which had a high consistency with histopathological diagnosis(kappa=0.817).Conclusion The combination of high-frequency and low-frequency ultrasound in the diagnosis of PLG is efficacious,which might guide the clinical strategy for management of PLG.

Polypoid lesions of gallbladderLow-frequency ultrasoundHigh-frequency ultrasoundLaparoscopic cholecystectomyHistopathologyDiagnosis

贾永利、王鹏川、郭伟、孙东莹

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475000 河南省开封市人民医院超声科

河南大学第一附属医院超声科

胆囊息肉样病变 低频超声 高频超声 组织病理学 诊断

河南省医学科技攻关计划项目

LHGJ20220649

2024

实用肝脏病杂志
中华医学会安徽分会

实用肝脏病杂志

CSTPCD
影响因子:1.362
ISSN:1672-5069
年,卷(期):2024.27(2)
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