【摘要】 目的总结壶腹癌的声像图特征,探讨提高其显示率的方法。方法对我院超声诊断并经手术或CT证实的23例壶腹癌的声像图进行回顾性分析总结,扫查时对胆总管扩张者按常规追踪胆总管至壶腹部,显示不清者令患者一次饮水500ml以上,采取不同的体位,仔细观察胆总管下段、胰头及充盈的十二指肠壶腹,必要时令患者深呼吸、局部加压或咳嗽,动态观察病变部位及其与以上三者的关系。结果1.饮水后右侧卧位比平卧位、坐位图像清晰,配合深呼吸、咳嗽,动态观察有意义。2.壶腹癌声像图分以下四型团块型11例(48%);乳头型3例(13%);厚壁狭窄型5例(22%);末端堵塞型2例(9%);2例仅显示胆管全程扩张型,未见明显占位病灶。结论超声检查并辅以简便易行的辅助方法能较好地显示壶腹癌及其与周围结构的关系,是壶腹癌诊断重要的检查手段。更多还原

【Abstract】 Objective To explore the ultrasonographie features of ampulla Vater carcinoma and to evaluate ultrasonographic diagnostic rate.Methods The sonograms of 23 cases with ampulla carcinoma confirmed by operation or CT were retrospectively analysed.The cases with choledochectasia were routinely probed from choledochos to ampulla.The difficult cases were asked to drink water more than 500 ml.The inferior of ampulla,head of pancreas and the engorged duodenum were observed carefully with various postures,deep breath、compression and cough if necessary.The relationship between the lesions and the above three parts were kinetically observed.Results 1.Compared with the recumbent position,the picture of right lateral decubitus position was more lucid.Dynamic observation conjugated with deep breath and cough was also necessary.2.The ampulla carcinoma were divided into four grades on ultrasound:Of the 23 cases,11 cases belonged to the papillary type,3 cases were stenotic with thickened wall,5 cases were with distal obstruction,2 cases merely displayed entire choledochectasis without occupying masses.Conclusions Ultrasound combined with simple check method is helpful in detecting ampulla carcinoma and the adjacent anatomic relationship,which is the important means for ampulla carcinoma diagnosis.更多还原