GB-RADS、CEUS和超声微血流成像判定胆囊息肉样病变性质价值研究*

doi:10.3969/j.issn.1672-5069.2026.01.039

摘要/Abstract

摘要： 目的分析胆囊壁增厚超声检查评估分级系统(GB-RADS)、超声造影(CEUS)和超声微血流成像技术判定胆囊息肉样病变(GPL)性质的价值。方法 2022年1月～2024年12月我院诊治的114例GPL患者,均接受CEUS、超声微血流成像分级和GB-RADS分级检查,行外科手术治疗。应用Kappa一致性检验评估诊断价值。结果经手术后组织病理学检查,发现胆囊癌16例(14.0%)和良性病变98例(86.0%);恶性病变CEUS呈高增强、病灶内血管多支和增强为快进快出占比分别为81.3%、93.7%和87.5%,均显著高于良性病变的46.9%、17.3%和39.8%(P<0.05);恶性病变超声微血流成像3～4级占比为100.0%,显著高于良性病变的60.2%(P<0.05);恶性病变GB-RADS 3～5级占比为81.3%,显著高于良性病变的21.4%(P<0.05);Kappa一致性检验显示,CEUS判定GPL性质的敏感度、特异度和准确率分别为81.3%、83.7%和83.3%,GB-RADS分级诊断分别为81.3%、78.6%和78.9%,均显著优于超声微血流成像分级诊断(分别为100.0%、39.8%和48.2%,P<0.05)。结论采用多种超声技术综合评估GPL性质能提高判定的准确性,值得临床深入研究。

关键词: 胆囊息肉样病变, 超声造影, 超声微血流成像, 胆囊壁增厚超声检查评估分级系统, 诊断

Abstract: Objective The aim of this study was to investigate the application of gallbladder reporting and data system (GB-RADS), contrast-enhanced ultrasound (CEUS) and ultrasound micro-flow imaging in the diagnosis of gallbladder polypoid lesion (GPL) properties. Methods 114 patients with GPL were encountered in out hospital between January 2022 and December 2024, and all underwent ultrasound micro-flow imaging and CEUS scan for GB-RADS grading. The patients with GPL received radical or conventional surgical resection. Kappa consistency test was applied to evaluate the diagnostic performance. Results Histo-pathological examination found gallbladder cancer in 16 cases(14.0%) and benign lesions in 98 cases (86.0%), including gallbladder polyps in 72 cases, adenomas in 10 cases and gallbladder adenomyomatosis in 16 cases; the proportion of high enhancement in CEUS, multiple vessels in the lesions and fast in and fast out of enhancement model in the malignant lesions were 81.3%, 93.7% and 87.5%, all significantly higher than 46.9%, 17.3% and 39.8%(P<0.05) in benign lesions; the proportion of ultrasound micro-flow imaging grade 3-4 in malignant lesions was 100.0%, much higher than 60.2% in benign lesions (P<0.05); the proportion of GB-RADS grade 3-5 was 81.3%, much higher than 21.4% in benign lesions (P<0.05); Kappa consistency test showed the sensitivity, specificity and accuracy by CEUS in judging the GPL properties were 81.3%, 83.7% and 83.3%, and by GB-RADS were 81.3%, 78.6% and 78.9%, both much superior to 100.0%, 39.8% and 48.2%, respectively (P<0.05) by ultrasound micro-flow imaging. Conclusion The assessment of GPL property by multiple ultrasonography might be helpful in clinical practice, which warrants further investigation.

Key words: Gallbladder polypoid lesion, Contrast-enhanced ultrasound, Ultrasound micro-flow imaging, Gallbladder reporting and data system, Diagnosis

朱琳, 毕娟, 严琪. GB-RADS、CEUS和超声微血流成像判定胆囊息肉样病变性质价值研究^*[J]. 实用肝脏病杂志, 2026, 29(1): 153-156.

Zhu Lin, Bi Juan, Yan Qi. GB-RADS, CEUS and ultrasound micro-flow imaging in the diagnosis of gallbladder polypoidlesion properties[J]. Journal of Practical Hepatology, 2026, 29(1): 153-156.

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GB-RADS、CEUS和超声微血流成像判定胆囊息肉样病变性质价值研究^*

GB-RADS, CEUS and ultrasound micro-flow imaging in the diagnosis of gallbladder polypoidlesion properties

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