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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。
Objective To summarize the sonographic features of ampulla carcinoma and to explore ways to improve its display rate. Methods A retrospective analysis was made on the sonographic findings of 23 cases of ampulla carcinoma diagnosed by ultrasonography in our hospital and confirmed by surgery or CT. During the scan, the common bile duct dilator was traced to the ampulla of the common bile duct with unclear signs Patients with more than 500ml of drinking water to take a different position, carefully observe the common bile duct, pancreatic head and filling the ampulla of the duodenum, if necessary, make the patient take a deep breath, local pressure or cough, dynamic observation of the lesion and the above three Relationship. Results 1. After drinking the right lateral position than the supine position image is clear, with deep breathing, cough, dynamic observation of significance. 2. Ampullary carcinoma was classified into the following four types of lumps in 11 cases (48%); papillary type in 3 cases (13%), thick-wall stenosis in 5 cases (22%), terminal blockage in 2 cases (9% ); 2 cases only showed full dilatation of bile duct, no obvious lesions. Conclusion Ultrasonography combined with simple and convenient auxiliary methods can better display the relationship between ampulla and its surrounding structures and is an important diagnostic tool for ampullary carcinoma.