【摘要】 目的：探讨胆道闭锁（Biliary atresia,BA）患儿常规超声表现特征，以提高BA超声诊断准确率。方法：回顾性分析32例BA患儿的超声表现并与手术探查及病理结果对照。结果：32例BA患儿常规超声图像表现为：（1）肝门部三角条索征（Triangular cord sign,TC）9例；（2）胆囊表现异常32例，其中胆囊缺如5例，胆囊收缩异常27例（合并胆囊瘪小和/或囊壁僵硬、增厚22例）；（3）肝门部囊肿1例；（4）肝包膜下血流阳性4例；（5）肝动脉增宽5例；（6）肝门淋巴结增大1例；（7）肝脏增大11例，脾脏增大1例。32例BA手术探查发现所有患儿胆囊形态异常、肝门均见纤维条索、肝脏表面可见肝包膜下蜘蛛状毛细血管扩张。病理检查示肝门纤维化、肝细胞及毛细胆管不同程度淤胆。结论：超声显示婴儿胆囊异常、TC征、肝门部囊肿其中任何一种阳性征象时，应高度警惕BA可能。其他超声表现如肝动脉直径增宽、肝包膜下血流阳性、肝门淋巴结肿大、肝脏增大等仅作为诊断BA的辅助指标。更多还原

【Abstract】 Objective: To investigate the characteristics of routine ultrasound performance in children with biliary atresia(BA) and to improve the accuracy of ultrasound diagnosis of BA. Methods: A retrospective analysis of ultrasound findings in 32 children with BA was conducted, and the results were compared with surgical exploration and pathology. Results: The routine ultrasound images of the 32 children with BA included the following findings: (1)Additionally, the triangular cord sign(TC) was observed in the hilar region in 9 cases. (2)32 cases of abnormal gallbladder manifestations, of which 5 were missing gallbladder, and 27 cases of abnormal gallbladder contraction (22 cases of combined with small gallbladder deflation and/or stiff and thickened cyst wall). (3)Hepatoportal cysts were present in 1 case. (4)Subpericardial blood flow was positive in 4 cases. (5)Hepatic artery widening was detected in 5 cases. (6)Hepatic hilar lymph node enlargement was found in 1 case. (7)Liver enlargement was observed in 11 cases, spleen enlargement was noted in 1 case. A totall of 32 BA surgery investigations found that all children had abnormal gallbladder morphology, fibrous cords were seen in the liver hilar hilar, and spider-like capillaries were dilated under the liver envelope. Pathological examinations indicate different degrees of hilar fibrosis, hepatocytes and capillary bile ducts. Conclusion: Ultrasound should maintain a high level of vigilance for the potential presence of BA when any of the positive signs of gallbladder abnormality, TC sign, and hepatoportal cyst are observed in infants. Other ultrasound manifestations, such as an increased diameter of the hepatic artery, positive hepatic subcapsular blood flow, enlarged hilar lymph nodes, and liver enlargement, should be used solely as auxiliary indicators for the diagnosis of BA.更多还原