胆囊隆起性病变的致病危险因素分析及其影像学诊断

发布时间：2018-01-02 05:05

本文关键词：胆囊隆起性病变的致病危险因素分析及其影像学诊断　出处：《上海交通大学》2015年博士论文　论文类型：学位论文

【摘要】：目的明确胆囊隆起性病变的致病危险因素并比较超声造影及增强CT对肿瘤性及非肿瘤性病灶鉴别诊断能力。背景胆囊隆起性病变分为肿瘤性及非肿瘤性两类,其致病危险因素尚未有明确定论。由于两者的治疗原则不同,故对病灶类型的准确鉴别至关重要。目前多种影像学手段被应用于病灶性质的鉴别,但其鉴别效能尚不明确。方法分析2014年1月至2014年12月至我院体检中心行健康查体人群的病史资料及检验结果,描述胆囊隆起性病变的一般规律,并通过Logistic回归分析疾病相关危险因素。同时对于2013年10月至2014年12月间至我科就诊且病灶最大径大于10mm的胆囊隆起性病变患者,通过对比超声造影、增强CT及手术病理结果,比较两种影像学手段对胆囊隆起性病变病理性质的鉴别能力。结果胆囊隆起性病变在此特定人群的患病率为5.22%,其中男性患病率为6.35%,女性患病率为3.61%。年龄(P=0.000),性别(P=0.000),超重(BMI25)(P=0.011),总胆固醇(P=0.003),高密度脂蛋白(P=0.000),低密度脂蛋白(P=0.000),合并脂肪肝(P=0.000)以及合并颈动脉斑块(P=0.000)等指标在胆囊隆起性病变患病人群及正常人群间存在差异。Logistic回归分析表明男性、超重、合并脂肪肝及颈动脉斑块、高总胆固醇及高低密度脂蛋白是疾病致病的危险因素。对比超声造影、增强CT及手术病理结果发现：对于最大径超过10mm的病灶而言,超声造影对肿瘤性病灶的诊断灵敏度为73.3%,特异度为83.3%；而增强CT的诊断灵敏度为93.3%,特异度为75.0%。结论胆囊隆起性病变在我国东部沿海大城市人口中的发病率与西方报道基本持平,绝大部分患者病灶最大径小于10mm。男性,中年(40-60岁),超重(BMI25),合并脂肪肝及动脉粥样硬化斑块,血总胆固醇及LDL水平的上升可视为疾病的危险因素。超声造影及薄层增强CT均对胆囊隆起性病灶肿瘤性及非肿瘤性的术前鉴别有一定作用,对于最大径超过10mm的病灶而言,增强CT对病灶性质的判断准确度优于超声造影。
[Abstract]:Objective to identify the risk factors of cholecystic protuberance lesions and to compare the ability of contrast-enhanced CT and contrast-enhanced ultrasonography in the differential diagnosis of neoplastic and non-neoplastic lesions. Background Cholecystic eminence lesions can be divided into two categories: neoplastic and non-neoplastic. There is no clear conclusion on the risk factors of the disease. Because of the different principles of treatment, it is very important for the accurate identification of lesion types. At present, many imaging methods have been used to distinguish the nature of the lesions. Methods from January 2014 to December 2014, the history and results of health examination were analyzed. To describe the general law of gallbladder protuberance lesions. The disease risk factors were analyzed by Logistic regression analysis. At the same time, for the STD with cholecystic eminence larger than 10mm in the period from October 2013 to December 2014, the largest diameter of the lesion was larger than 10mm. Become a patient. Contrast contrast-enhanced contrast-enhanced CT and surgical and pathological results. Results the prevalence rate of cholecystic eminence lesions in this particular population was 5.22 and the prevalence rate of male was 6.35%. The prevalence rate of female was 3.61. Age was 0.000, sex was 0.000, overweight BMI25 / P0. 011, total cholesterol was 0.003). High density lipoprotein (HDLP) and low density lipoprotein (LDL-C) were 0.000 and 0.000 respectively. Combined with fatty liver and carotid plaques (P = 0.000) and carotid plaque (n = 0.000, P = 0.000, P = 0.000, P = 0.000). Logistic regression analysis showed that there was a significant difference between the patients with cholecystic protuberance disease and the normal population. Overweight, fatty liver and carotid plaque, high total cholesterol and high density lipoprotein were risk factors of disease. Contrast-enhanced contrast-enhanced ultrasonography. Contrast-enhanced CT and pathology showed that the sensitivity and specificity of contrast-enhanced contrast-enhanced ultrasonography in the diagnosis of tumor lesions were 73.3 and 83.3 for the lesions with a maximum diameter of more than 10 mm. The diagnostic sensitivity of enhanced CT was 93.3 and the specificity was 75.0. Conclusion the incidence of cholecystic protuberance lesions in the population of large cities along the eastern coast of China is basically the same as that reported in western countries. The largest diameter of lesions in most patients was less than 10mm. male, aged 40-60 years old, was overweight and complicated with fatty liver and atherosclerotic plaques. The elevation of serum total cholesterol and LDL levels can be regarded as the risk factors of the disease. Both contrast-enhanced CT and contrast-enhanced CT can play a certain role in the preoperative differential diagnosis of neoplastic and non-neoplastic lesions of gallbladder eminence. For the lesions with a maximum diameter of more than 10 mm, the accuracy of contrast-enhanced CT in judging the nature of lesions is superior to that of contrast-enhanced ultrasonography.
【学位授予单位】：上海交通大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R575.6;R816.5

【相似文献】