探讨超声检查对胆道闭锁的诊断价值
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摘要
目的探讨超声检查在胆道闭锁(BA)诊断中的价值。方法收集291例因黄疸就诊的患儿的超声资料,男婴151例,女婴140例,日龄10～89d。BA组132例,非BA组159例。比较"三角索带征"、胆囊及肝动脉在两组病例之间的差异。结果 BA组"三角索带征"显示率为84.84%,厚度为(0.50±0.04)cm,非BA组显示率为9.43%,厚度为(0.21±0.06)cm,两组间比较有显著性差异(P值=0.00)。BA组胆囊显示率为77.27%,非BA组胆囊显示率为100%,胆囊长径及短径在两组间存在显著性差异,P值分别为0.001和0.035。BA组胆囊形态异常占98.03%,非BA组占29.56%,两组间存在显著性差异(P值=0.01)。BA组胆囊收缩功能不良率(100%)明显高于非BA组(37.10%)。BA组肝动脉内径明显大于非BA组(P值=0.043)。结论肝门区"三角索带征"结合胆囊形态及功能异常对胆道闭锁诊断有重要意义。
Objective To evaluate the value of ultrasound in diagnosis of biliary atresia(BA).Methods Biliary atresia was found in 132 infants and ruled out in 159 cases including 151 male and 140 female,Comparations of the difference of triangular cord sign,gallbladder,hepatic artery diameter between the two groups were made.Results In BA group,Triangular cord sign was found in 112 patients and the thickness was(0.50±0.04)cm;In non biliary atresia(Non-BA)group,Triangular cord sign was found in 15 patients and the thickness was(0.21±0.06)cm,with a significant difference between the two groups(P=0.000);The gallbladder display rate was 77.27% in BA group and 100% in Non-BA group,the size of gallbladder was significant difference between the two groups.The occurrence rate of abnormal gallbladder shape(98.03%) and the contractibility of gallbladder dysfunction rate(100%)of BA group were significantly higher than those of the Non-BA group(29.56% and 37.10% respectively).The hepatic artery diameter of BA group was more than that of Non-BA group.Conclusions Triangular cord sign combined with abnormal gallbladder shape and dysfunction were useful to make the diagnosis of biliary atresia.
Objective To evaluate the value of ultrasound in diagnosis of biliary atresia(BA).Methods Biliary atresia was found in 132 infants and ruled out in 159 cases including 151 male and 140 female,Comparations of the difference of triangular cord sign,gallbladder,hepatic artery diameter between the two groups were made.Results In BA group,Triangular cord sign was found in 112 patients and the thickness was(0.50±0.04)cm;In non biliary atresia(Non-BA)group,Triangular cord sign was found in 15 patients and the thickness was(0.21±0.06)cm,with a significant difference between the two groups(P=0.000);The gallbladder display rate was 77.27% in BA group and 100% in Non-BA group,the size of gallbladder was significant difference between the two groups.The occurrence rate of abnormal gallbladder shape(98.03%) and the contractibility of gallbladder dysfunction rate(100%)of BA group were significantly higher than those of the Non-BA group(29.56% and 37.10% respectively).The hepatic artery diameter of BA group was more than that of Non-BA group.Conclusions Triangular cord sign combined with abnormal gallbladder shape and dysfunction were useful to make the diagnosis of biliary atresia.
引文
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[6]HWANG S M,JEON T Y,YOO S Y,et al.Early US findings of biliary atresia in infants younger than 30days[J].Eur Radiol,2018,28(4):1771-1777.
[7]张雪华,陈文娟,杨芳,等.超声在先天性囊肿型胆道闭锁及胆总管囊肿的鉴别诊断探讨[J].中国超声医学杂志,2016,32(7):619-621.
[2]JAWAHEER G,PIERRO A,LLOYD D A,et al.Gallbladder contractility in neonates:effects of parenteral and enteral feeding[J].Archieves of Disease in Childhood,1995,72(3):F200-202.
[3]ZHOU L Y,WANG W,SHAN Q Y,et al.Optimizing the USdiagnosis of biliary atresia with a modified triangular cord thickness and gallbladder classification[J].Radiology,2015,277(1):181-191.
[4]IMANIEH M H,DEHGHANI S M,BAGHERI M H,et al.Triangular cord sign in detection of biliary atresia:Is it a valuable sign[J].Dig Dis Sci,2010,55(1):172-175.
[5]SAXENA A K,MITTAL V,SODHI K S.Triangular cord sign in biliary atresia:does it have prognostic and medicolegal significance[J].Radiology,2012,263(2):621.
[6]HWANG S M,JEON T Y,YOO S Y,et al.Early US findings of biliary atresia in infants younger than 30days[J].Eur Radiol,2018,28(4):1771-1777.
[7]张雪华,陈文娟,杨芳,等.超声在先天性囊肿型胆道闭锁及胆总管囊肿的鉴别诊断探讨[J].中国超声医学杂志,2016,32(7):619-621.