先天性肥厚性幽门狭窄的X线和超声诊断

目的探讨先天性肥厚性幽门狭窄(CHPS)的X线和超声的诊断价值。方法经手术证实的先天性肥厚性幽门狭窄患儿52例,对其X线钡餐检查和超声检查结果进行分析。结果 52例患儿X线钡餐检查均见胃排空延迟,幽门线样征、幽门鸟嘴征45例次,胃窦肩征34例次,双轨征21例次,蕈伞征28例次;超声检查共31例,其中29例幽门环肌厚度≥4mm,另2例分别为3.7mm和3.6mm;22例测量幽门管长度≥15mm,17例测量幽门管直径≥12mm。结论超声检查可直接显示幽门管结构,准确性高,重复检查方便,避免X线照射,宜作为首选;X线钡餐检查CHPS有典型征像,对其他呕吐性疾病有重要鉴别诊断价值。对超声检查不能明确为CHPS者须进一步X线钡餐检查。

The value of X-ray and ultrasound examination in diagnosis of congenital hypertrophic pyloric stenosis

Objective To investigate the value of X-ray and ultrasound examination in diagnosis of congenital hypertrophic pyloric stenosis(CHPS).Methods The data reported by X-ray and ultrasound examinations in 52 children with CHPS confirmed by operation were analyzed retrospectively.Results On the X-ray,the stomach empty of barium meal was delayed in all 52 cases,pyloric string sign and pyloric angle sign were seen in 45 cases,sinus ventriculi shoulder sign was showed in 34 cases,double track signs were seen in 21 cases,and mushroom sign was seen in 28 cases.Of 31 cases examined by ultrasound,the thickness of pyloric ring muscle was ≥4 mm in 29 cases,which of the rest two cases was 3.7 mm and 3.6 mm,respectively.The length of pyloric canal measured by ultrasound was ≥15 mm in 22 cases and the diameter of pyloric canal ≥12 mm in 17 cases.Conclusion The ultrasound examination shows pyloric structure directly with an accuracy,convenience,avoidance of X-ray hurt.The X-ray barium meal examination can show a typical sign of CHPS,which is important in distinguishing CHPS from other vomitting disease.The X-ray barium meal examination should be performed if a diagnosis of CHPS can not be made definitely by ultrasound.