Медицинская литература. Новинки

 

 

 

 

 

 

Ультразвуковая диагностика рака желчного пузыря: современные возможности и ограничения

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Рак желчного пузыря (РЖП) хотя в целом считается редким, является наиболее распространенным злокачественным заболеванием желчных путей и составляет 80-95%. Ранняя диагностика РЖП очень важна, так как его клинические проявления неспецифичны и могут наблюдаться при воспалительных процессах, поэтому опухоль чаще выявляют достаточно поздно, уже в период ее распространения за пределы органа. В статье освещены особенности этиологии и клинического течения РЖП, которые обусловливают сложности его диагностики и дифференциальной диагностики. Представлен обзор возможностей и ограничений ультразвукового метода исследования при диагностике РЖП с применением различных ультразвуковых модальностей (В-режим, дуплексное сканирование, трехмерная реконструкция, эндосонография, применение контрастных ультразвуковых средств, эластометрия). Проанализированы причины ложноположительных и ложноотрицательных случаев диагностики РЖП. Показаны наиболее эффективные методы дообследования пациентов при сложностях дифференциальной ультразвуковой диагностики.

Ключевые слова:
рак желчного пузыря, этиология, клиника, ультразвуковая диагностика, возможности, ограничения, gall bladder cancer, etiology, clinical features, ultrasound diagnostics, capabilities, limitations

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Ultrasonic Diagnosis of Gall Bladder Cancer: Modern Capabilities, and Limitations

Gall Bladder Cancer of a (GBC) though in general is considered rare, is the most widespread malignant disease of biliary tract and makes 80-95%. Early diagnostics of GBC is very important as its clinical manifestations aren''t specific and can be observed at inflammatory processes. Therefore the tumor is revealed more often late enough, already during its distribution out of gall bladder. Features of an etiology and a clinical picture of GBC, which cause difficulties of its diagnostics and differential diagnostics are covered in article. The review of opportunities and restrictions of an ultrasonic method of research at diagnostics of GBC with application of various ultrasonic modalities (B-mode, duplex scanning, three-dimensional reconstruction, endosonography, application of contrast ultrasonic agents, elastometry) is submitted. The reasons of false positive and false and negative cases of diagnostics of GBC are analysed. The most effective methods of an additional examination of the patients at difficulties of differential ultrasonic diagnostics are shown.

Keywords:
рак желчного пузыря, этиология, клиника, ультразвуковая диагностика, возможности, ограничения, gall bladder cancer, etiology, clinical features, ultrasound diagnostics, capabilities, limitations