低频与高频超声联合诊断胆囊息肉样病变价值分析*

doi:10.3969/j.issn.1672-5069.2024.02.037

摘要/Abstract

摘要： 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。

关键词: 胆囊息肉样病变, 低频超声, 高频超声, 组织病理学, 诊断

Abstract: 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.

Key words: Polypoid lesions of gallbladder, Low-frequency ultrasound, High-frequency ultrasound, Laparoscopic cholecystectomy, Histopathology, Diagnosis

贾永利, 王鹏川, 郭伟, 孙东莹. 低频与高频超声联合诊断胆囊息肉样病变价值分析^*[J]. 实用肝脏病杂志, 2024, 27(2): 307-310.

Jia Yongli, Wang Pengchuan, Guo Wei, et al.. High-frequency and low-frequency ultrasound in the diagnosis of polypoid lesions of gallbladder[J]. Journal of Practical Hepatology, 2024, 27(2): 307-310.

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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^*

High-frequency and low-frequency ultrasound in the diagnosis of polypoid lesions of gallbladder

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