标题：胆管灌洗在超声胆管造影中的应用价值

      作者：陈列，田超，张植兰，朱才义    (中南大学湘雅医学院附属海口医院超声医学科，海南 海口 570208)

      卷次： 2017年28卷18期

      【摘要】 目的 进一步完善超声胆管造影(B-CEUS)的操作步骤，探讨胆管灌洗在超声胆管造影中的应用价值。方法 选取2016年4月至2017年4月于中南大学湘雅医学院附属海口医院超声医学科接受 IB-CEUS的21例肝门部梗阻患者，先不经胆道灌洗步骤注入超声造影剂(UCA)进行胆管造影，待UCA效果消退后经引流导管灌洗肝内胆管系统，再行胆管造影。比较患者灌洗前和灌洗后肝内1级和3级胆管（肝段胆管）的即刻显影率。结果 胆管灌洗前，患者1级胆管1例显示不满意，20例显示满意，胆管灌洗后，21例患者1级胆管均显示满意，灌洗前后1级胆管即刻显示率比较，差异无统计学意义(P>0.05)；胆管灌洗前，患者3级胆管6例显示不满意，15例显示满意，灌洗后，1例显示不满意，20例显示满意，灌洗前后3级胆管即刻显示率比较，差异有统计学意义(P<0.05)。结论 在进行IB-CEUS前加入胆管灌洗这个步骤可以提高 IB-CEUS中3级胆管的显示率，从而有望更精确的诊断胆管疾病。
      【关键词】 胆管灌洗；超声胆管造影；胆管
      【中图分类号】 R445.1 【文献标识码】 A 【文章编号】 1003—6350（2017）18—3010—03

Effects of biliary lavage in intra-biliary contrast-enhanced ultrasound.
CHEN Lie, TIAN Chao, ZHANG Zhi-lan,ZHU Cai-yi. Department of Ultrasound, Central South University Xiangya School of Medicine Affiliated Haikou Hospital,Haikou 570208, Hainan, CHINA
【Abstract】 Objective To further improve and standardize the operation of intra-biliary contrast-enhanced ultra-sound (IB-CEUS) and evaluate the application value of biliary lavage in IB-CEUS. Methods Twenty-one patients ofhepatic portal obstruction undergoing IB-CEUS in Central South University Xiangya School of Medicine Affiliated Haik-ou School from April 2016 to April 2017 were enrolled in the study. We first performed IB-CEUS with ultrasound con-trast agent (UCA) without the biliary lavage process, then after the effect of UCA receded, lavage the intrahepatic bile ductsystem through drainage catheter, and performed IB-CEUS again. The immediate display rates of the intrahepatic stage 1and 3 bile duct (hepatobiliary duct) were compared before and after the biliary lavage. Results Before the biliary lavage,20 patients were satisfied for stage 1 bile duct and 1 was unsatisfied, versus 21 were satisfied and 0 was unsatisfied afterthe biliary lavage (P>0.05). Before the biliary lavage, 15 patients were satisfied for stage 3 bile duct and 6 were unsatis-fied, compared with 20 were satisfied and 1 was unsatisfied after the biliary lavage (P<0.05). Conclusion The additionof the biliary lavage process before IB-CEUS can improve the immediate display rate of stage 3 bile ducts in IB-CEUS,which could lead to more accurate diagnosis of bile duct disease.
      【Key words】 Biliary lavage; Intra-biliary contrast-enhanced ultrasound (IB-CEUS); Bile duct·论 著·doi:10.3969/j.issn.1003-6350.2017.18.025