计算机断层扫描评估胆囊肿块与组织病理学相关性

Dr. SM Hedayetul Islam Sagar, Dr. Nashid Amir, Dr. Md. Husnaion Zubery
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摘要

背景:在肝外胆管癌患者中,尽管进行了全面的术前评估,但仍经常在探查过程中发现无法切除的疾病,从而导致不必要的开腹手术。胆囊癌在胃肠道恶性肿瘤中排名第五,仅次于结直肠癌、胰腺癌、胃癌和食管癌。研究目的该研究旨在确定计算机断层扫描(CT)在诊断胆囊肿块中的诊断作用。研究方法这项病例对照研究于 2018 年 3 月至 2018 年 8 月在孟加拉国拉杰沙希市拉杰沙希医学院附属医院放射与影像科进行。研究纳入了 65 名确诊为胆囊肿块的患者,通过目的性抽样选出。采用SPSS 23.0版本进行数据分析。结果CT 扫描能准确预测胆囊肿块的各种特征,对腺癌、鳞癌、胆囊炎、转移瘤、胆囊息肉和腺瘤显示出较高的敏感性、特异性和准确性,阳性和阴性预测值均≥95%。慢性胆囊炎的敏感性超过 83%。总体而言,CT 诊断对所有特征的准确率至少为 88.9%。组织病理学评估也发现了几乎相似的胆囊肿块特征。结论计算机断层扫描(CT)是术前鉴别胆囊肿瘤的重要诊断工具。值得注意的是,CT 扫描有助于对胆囊肿瘤患者采取合理的治疗方法。
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Computed Tomography Evaluation of Gall Bladder Mass with Histopathological Correlation
Background: In extrahepatic biliary carcinoma patients, unresectable disease is frequently discovered during exploration despite thorough preoperative assessment, leading to unnecessary laparotomy. Gallbladder carcinoma ranks fifth among gastrointestinal malignancies, following colorectal, pancreatic, gastric, and esophageal carcinomas. Aim of the study: The aim of the study was to establish the diagnostic usefulness of computed tomography (CT) in the diagnosis of gallbladder mass. Methods: This case-control study was conducted at the Department of Radiology and Imaging, Rajshahi Medical College Hospital, Rajshahi, Bangladesh from March 2018 to August 2018. The study included 65 patients diagnosed with a gallbladder mass, selected through purposive sampling. SPSS version 23.0 was utilized for data analysis. Results: CT scans accurately predicted various features of gallbladder mass, showing high sensitivity, specificity, and accuracy, with positive and negative predictive values of ≥95% for adenocarcinoma, squamous carcinoma, cholecystitis, metastases, GB polyp, and adenoma. Chronic cholecystitis sensitivity was over 83%. Overall, CT diagnosis performed at least 88.9% across all features. The histopathological assessment also detected nearly similar features of gallbladder mass. Conclusion: Computed tomography (CT) serves as a valuable diagnostic tool for distinguishing gallbladder neoplasms preoperatively. It is worth noting that CT scans aid in the rational management approach for patients with gallbladder neoplasms.
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