口服胃肠超声助显剂对胆总管显像的影响

摘要

目的探讨口服胃肠超声助显剂对胆总管全程显像的改善情况。资料与方法78例经术后病理证实的胆总管梗阻患者，术前均行常规超声、口服胃肠超声助显剂后超声（超声造影）、磁共振胆管造影（MRCP）、经内镜逆行胰胆管造影（ERCP）检查，并与手术病理结果比较，评价4种影像方法的诊断效果。结果超声造影、常规超声、MRCP、ERCP对胆总管全程的显示率分别为93.59%、21.79%、97.44%、100.00%，对胆管病灶的显示率分别为91.03%、58.97%、92.31%、97.44%，超声造影与MRCP、ERCP对胆总管全程及胆管病灶的显示率均无显著差异（χ2=0.598、3.306, P>0.05），但超声造影对胆总管全程及胆管病灶的显示率明显高于常规超声（χ2=82.360、21.368, P<0.001）。超声造影对完整胰头及十二指肠乳头的显示率分别为100.00%、71.79%，明显高于常规超声的52.56%、2.56%（χ2=48.504、80.031, P<0.001）。结论应用口服胃肠超声助显剂超声检查能明显提高胆总管及病灶的显示率，是一种切实可行、简单而可靠的方法。%Purpose To explore the role of oral gastrointestinal echogenic contrast agent in improving imaging of the whole common bile duct. Materials and Methods Seventy-eight patients with common bile duct obstruction confirmed by surgery and pathology were recruited in the study. Preoperative routine ultrasound, oral gastrointestinal echogenic contrast agent ultrasound (ultrasound contrast), magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiopancreatography (ERCP) were retrospectively analyzed, and findings were compared with pathology results. Diagnosis efficiency of these four methods was evaluated. Results Display rate of the common bile duct of ultrasound contrast, routine ultrasound, MRCP and ERCP were 93.59%, 21.79%, 97.44%and 100%, respectively. Display rate of the bile duct lesion was 91.03%, 58.97%, 92.31%, and 97.44%, respectively. There was no difference in displaying the whole common bile duct and bile duct lesions between ultrasound contrast and MRCP as well as ERCP (χ2=0.598, 3.306;P>0.05). Ultrasound contrast was superior to routine ultrasound in displaying the whole common bile duct and bile duct lesions (χ2=82.360, 21.368; P<0.001). The rate of ultrasound contrast in displaying whole pancreas head and duodenal papilla was 100.00% and 71.79%, respectively, which was much higher than those of routine ultrasound (χ2=48.504, 80.031; P<0.001). Conclusion Oral gastrointestinal echogenic contrast agent may improve the display rate of the common bile duct and the lesions in it, which is a simple and reliable method in practice.