原發性膽囊癌之超音波診斷

Primary Carcinoma of the Gallbladder-Sonographic Diagnosis with a Review of 15 Cases

王至俊(J-June Wang) ； 周宜宏(Yi-Hong Chou) ； 許重權(C. C. Hsu) ； 蔡養德(Y. T. Tsai) ； 吳峻吉(C. C. Wu) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 9卷4期 (1984/12) Pp. 322-328

摘要

膽囊癌是較少見的癌症，由於傳統放射線檢查對此病未具敏感性及特異性，故其診斷率偏低。目前超音波檢查，已被廣泛地應用於膽囊疾患之篩檢，對膽囊壁及囊腔病變之偵測殊為經濟便捷。本文就榮民總醫院自69年10月至72年12月，三年多來，經病理證實，而做過超音波檢查的15個病例，作回溯性的分析其超音波圖像，此15例皆為男性，年齡由54歲至77歲（平均64歲），超音波檢查圖像，可分成四型：(Ia)腫瘤型有2例，(Ib)腫瘤型合併中心強音波有1例，(Ⅱ)浸潤型5例，(Ⅲ)息肉型4例，(W)合併息肉與侵潤型有3例絮另外有伴隨發現者包括：肝內腿管結石1例，胆結石8例；合併肝臟轉移者有2例，肝胆管擴張有4例與局部淋巴結腫大者1例；本文並討論所述各型服囊癌於超音波之鑑別診斷。

並列摘要

Gallbladder cancer is not an uncommon malignant tumor in the accessory organs of digestion. The conventional radiographic examinations are neither sensitive nor specific, and provide low diagnostic accuracy. Nowadays, medical ultrasonography is widely used as a screening method for gallbladder disorders. It is very cost-effective for detecting gallbladder wall and intraluminal pathology. We retrospectively analyzed the ultrasonograms of 15 pathologically proved gallbladder cancers in the three years' period from Oct. 1980 to Dec. 1983. All the cases were male, aged from 54 to 77 with a mean age of 64. The sonographic appearances can be divided into four types: (Ia) mass type, 2 cases; (Ib) mass type with central echo, 1 case; (Ⅱ) infiltrative type, 5 cases; (Ⅲ) fungating type, 4 cases; (Ⅳ) a combination of type Ⅱ and type Ⅲ, 3 cases. The associated findings include gall stones (8 cases), biliary stones (1 case), hepatic metastasis (2 cases), intrahepatic biliary dilatation (4 cases) and regional lymph node enlargement (4 cases). We also discuss the sonographic differential diagnosis in each type of gallbladder cancer.