超声与 CT 检查对肝胆管结石并发肝胆管癌的诊断价值

摘要

Objective:To analyze and explore the value of ultrasonography in the diagnosis of hepatoli-thiasis associated with cholangiocarcinoma in order to improve the clinical diagnosis rate .Method: 60 pa-tients with hepatolithiasis associated with cholangiocarcinoma treated in the department of Hepatobiliary Sur -gery of our hospital from Jan .2011 to Jan.2012 were selected and randomly divided into the observation group and the control group , 30 cases in each group .The patients in the observation group were inspected by the ultrasound , while the patients in the control group were examined by CT before the operation .Then the clinical diagnosis rate of patients was compared between two groups .Result: There were 18 patients con-firmed in the observation group with the rate of 60%;Four patients were confirmed the intraductal papillary carcinoma with the rate of 66.7%and two patients were the bile duct stenosis cancer with the rate of 50%. There were 22 patients in the control group were diagnosed with the rate of 73.3%;Three patients were con-firmed the intraductal papillary carcinoma with the rate of 50%and no one was the bile duct stenosis cancer . The diagnostic rate of the control group was higher than that of the observation group .There's statistically sig-nificant differences ( P<0.05);whereas the diagnostic rate of the intraductal papillary carcinoma and the bile duct stenosis cancer in the observation group was higher than that of the control group .There's statistically significant differences ( P<0.05) .Conclusion:It suggests that the ultrasound would be better than the CT on the diagnosis of the hepatolithiasis combined with the cholangiocarcinoma though both of them could make a contribution to clinical diagnosis .%目的：观察超声对肝胆管结石合并肝胆管癌的诊断率，为肝胆疾病的临床诊断提供可借鉴的方法。方法：选取2011年1月至2012年1月在我院肝胆外科就诊的肝胆管结石合并肝胆管癌患者60例，随机分为观察组和对照组。观察组30例患者于手术前行B超检查，对照组30例患者行CT检查，比较两组临床确诊率。结果：观察组确诊18例，确诊率为60．0％；胆管内乳头状癌4例，诊出率为66．7％；胆管壁狭窄型癌2例，诊出率为50％；对照组确诊22例，确诊率为73．3％；胆管内乳头状癌3例，诊出率为50％；未诊出胆管壁狭窄型癌病例。对照组确诊率优于观察组，差异具有意义（ P＜0．05）。观察组胆管内乳头状癌及胆管壁狭窄型癌的诊出率显著优于对照组，差异具有统计学意义（ P＜0．05）。结论：B超和CT在临床上均可诊断胆管结石合并肝胆管癌，但B超的临床确诊率优于CT，值得推广应用。