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肝胆系统超声检查

Authors
Umaprasanna S Karnam, MD
Jonathan B Kruskal, MD, PhD
K Rajender Reddy, MD
Section Editor
Sanjiv Chopra, MD, MACP
Deputy Editor
Anne C Travis, MD, MSc, FACG, AGAF
Translators
车颖, 主任医师，教授

引言

超声检查是侵袭性最小的放射学肝脏和胆道成像法。不同于计算机断层(computed tomographic, CT)扫描和磁共振成像(magnetic resonance imaging, MRI)，超声是一种可移动、快捷的检查手段，并可用于引导介入治疗。超声不使用电离辐射成像，因此可作为妊娠妇女、造影剂过敏患者或MRI禁忌患者的首选检查方法[1]。

本专题将讨论超声在评估肝脏和肝内外胆管中的作用。用超声评估胆囊在此仅作简要讨论，并将单独作更详细的讨论。 (参见“急性胆囊炎的发病机制、临床特征和诊断”，关于‘超声检查’一节和“成人无并发症胆石病”，关于‘经腹超声’一节和“胆囊癌：流行病学、危险因素、临床特点和诊断”，关于‘超声’一节和“胆囊息肉和胆固醇沉着病”，关于‘超声检查’一节)

技术

超声依靠定向声波的传递，定向声波以不同的选定频率穿过组织，随后计算机将反射声波的信号转换成屏幕上的解剖学图像。声波反射的程度取决于具有不同声学特性的组织间分界面。产生回声的程度取决于被评估组织反射或吸收超声波的能力。脂肪肝会在一定程度上会使超声束衰减，从而限制对肝脏实质的完整评估。相似地，医用超声波不通过空气传播；因此位于间位肠袢之下的肝脏显影效果较差[1]。

超声检查的正常测量结果 — 肝胆管系统中各结构的测量取决于获取测量结果的超声检查操作者的技术，因此在什么被认为是“正常”的方面存在差异性。然而，关于肝胆管系统中结构的预期大小现有一些大致的估计值：

●胆囊：胆囊壁厚度应小于或等于2mm(对于膨胀胆囊或空腹时的胆囊)。当受试者进食后，可见塌陷的胆囊，此时通常表现为胆囊壁增厚。胆囊的最大尺寸为5cm×10cm。

               

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Literature review current through: 2017-06 . | This topic last updated: 2015-09-25.
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