胆囊疾病的对比增强内镜超声检查

Contrast-enhanced endoscopic ultrasonography in gallbladder diseases.

作者信息

Hirooka Y, Naitoh Y, Goto H, Ito A, Hayakawa S, Watanabe Y, Ishiguro Y, Kojima S, Hashimoto S, Hayakawa T

机构信息

Second Department of Internal Medicine, Nagoya University School of Medicine, Japan.

出版信息

Gastrointest Endosc. 1998 Oct;48(4):406-10. doi: 10.1016/s0016-5107(98)70012-4.

DOI:10.1016/s0016-5107(98)70012-4

PMID:9786115

Abstract

BACKGROUND

The purpose of this study was to investigate the usefulness of contrast-enhanced endoscopic ultrasonography in gallbladder diseases.

METHODS

Subjects were 38 patients including 12 with adenocarcinoma, 2 adenosquamous carcinoma, 6 cholesterol polyp, 10 cholecystitis, and 8 adenomyomatosis. After endoscopic ultrasonography, sonicated albumin was intravenously injected and the enhanced effect on images of these lesions was determined. For malignancies we compared diagnostic accuracy (T factor, TNM classification) of endoscopic ultrasonography and contrast-enhanced endoscopic ultrasonography. Vascularity as shown by contrast-enhanced endoscopic ultrasonography and angiograms was compared.

RESULTS

Enhancement was observed in 11 patients with adenocarcinoma but not of those with adenosquamous carcinoma or cholesterol polyp. Angiography provided hypervascular images for all cases of adenocarcinoma, but all other lesions were hypovascular. In one case of adenocarcinoma, 3 cases of adenomyomatosis, and 8 cases of cholecystitis, there was a discrepancy between contrast-enhanced endoscopic ultrasonography images and angiograms with regard to vascularity. The accuracy of depth of tumor invasion for endoscopic ultrasonography was 78.6% (11 of 14) versus 92.9% (13 of 14) for contrast-enhanced endoscopic ultrasonography.

CONCLUSION

Contrast-enhanced endoscopic ultrasonography is useful in the diagnosis of gallbladder lesions.

摘要

背景

本研究旨在探讨对比增强内镜超声检查在胆囊疾病中的应用价值。

方法

研究对象为38例患者，包括12例腺癌、2例腺鳞癌、6例胆固醇息肉、10例胆囊炎和8例腺肌增生症。在内镜超声检查后，静脉注射超声乳化白蛋白，并确定其对这些病变图像的增强效果。对于恶性肿瘤，我们比较了内镜超声检查和对比增强内镜超声检查的诊断准确性（T因子、TNM分类）。比较了对比增强内镜超声检查和血管造影显示的血管情况。

结果

11例腺癌患者观察到增强，而腺鳞癌或胆固醇息肉患者未观察到增强。血管造影显示所有腺癌病例均为高血运图像，但所有其他病变均为低血运。在1例腺癌、3例腺肌增生症和8例胆囊炎病例中，对比增强内镜超声检查图像和血管造影在血管情况方面存在差异。内镜超声检查对肿瘤浸润深度的诊断准确率为78.6%（14例中的11例），而对比增强内镜超声检查为92.9%（14例中的13例）。