Kuroiwa M, Goto H, Hirooka Y, Furukawa T, Hayakawa T, Naitoh Y
Second Department of Internal Medicine, Nagoya University School of Medicine, Japan.
J Gastroenterol Hepatol. 1998 Jul;13(7):715-9. doi: 10.1111/j.1440-1746.1998.tb00719.x.
Intraductal ultrasonography (IDUS) was performed on 22 patients with extrahepatic bile duct cancer, using the percutaneous transhepatic approach. Intraductal ultrasonography images of the proximal invasion of the bile duct cancer were defined. In addition, three patients were examined through the peroral approach, to try to diagnose whether or not the cancer invaded to the bifurcation of the hepatic duct. Intraductal ultrasonography images obtained through the percutaneous approach could be classified into three patterns, types 1, 2 and 3, according to the features of the interior surface of the bile duct and the thickness of the bile duct wall. Type 1 images, which did not show protrusions into the bile duct lumen and had a bile duct wall of even thickness, were not likely to show bile duct cancer. Type 2 images showed protrusions of the tumour into the bile duct lumen and the surfaces of the protrusions were irregular. Type 3 images showed single or multiple low echoic papillary masses in the bile duct. Using the peroral technique, we considered all three cases to be type 1 and could diagnose that cancer had not invaded to the bifurcation of the hepatic ducts. From the results of this study, we suggest that proximal invasion of extrahepatic bile duct cancer can be diagnosed using IDUS.
对22例肝外胆管癌患者采用经皮经肝途径进行了胆管内超声检查（IDUS）。明确了胆管癌近端浸润的胆管内超声图像。此外，对3例患者采用经口途径进行检查，以试图诊断癌症是否侵犯至肝管分叉处。根据胆管内表面特征和胆管壁厚度，经皮途径获得的胆管内超声图像可分为三种模式，即1型、2型和3型。1型图像未显示胆管腔内有突出物，胆管壁厚度均匀，不太可能显示胆管癌。2型图像显示肿瘤突出至胆管腔内，突出物表面不规则。3型图像显示胆管内有单个或多个低回声乳头状肿块。采用经口技术，我们认为所有3例均为1型，可诊断癌症未侵犯至肝管分叉处。根据本研究结果，我们建议可使用IDUS诊断肝外胆管癌的近端浸润。
