新生儿全结肠无神经节细胞症X线诊断

目的：探讨新生儿全结肠无神经节细胞症X线诊断。材料与方法：1985年至1995年经X线检查后手术病理证实此病者18例。结果：腹部平片17例显示：中上腹小肠胀气伴气液面15例，直肠少气或无气16例。无1例结肠胀气。钡灌肠18例显示：结肠细小5例。结肠宽径多数近似正常、但肠管形态多不正常（包括僵直9例，锯齿状改变7例），结肠短缩12例，直肠壶腹消失14例。排钡延迟11例。结论：钡灌肠对诊断本病有重要价值。     

新生儿全结肠无神经节细胞症X线诊断

目的：探讨新生儿全结肠无神经节细胞症X线诊断。材料与方法：1985年至1995年经X线检查后手术病理证实此病者18例。结果；腹部平片17例显示：中上腹小肠胀气伴气液面15例，直肠少气或无气16例。无1例结肠胀气。钡灌肠18例显示：结肠细小5例。结肠宽径多数近似正常、但肠管形态多不正常(包括僵直9例，锯齿状改变7例)，结肠短缩12例，直肠壶腹消失14例。排钡延迟11例。结论：钡灌肠对诊断本病有重要价值。     

新生儿先天性巨结肠的X线诊断(附33例报告)

目的 探讨钡剂灌肠、腹部平片对新生儿先天性巨结肠X线诊断的价值.方法 搜集经手术证实、病理诊断的新生儿先天性巨结肠33例,分析钡剂灌肠、腹部平片典型的及不典型的X线表现,对所得的结果进行回顾性地研究.结果 本组33例新生儿中,钡剂灌肠发现为先天性巨结肠短段型1例,常见型16例,长段型2例,全结肠型5例;24 h随访钡剂潴留于整个结肠5例,部分结肠21例;直肠、乙状结肠不规则锯齿状改变2例.腹部平片表现为结肠低位不完全性梗阻及肠淤张20例;肠气偏少5例.结论 运用钡剂灌肠、腹部平片等方法,检查临床初诊为先天性巨结肠的新生儿,可以提供很有价值的X线诊断.     

婴幼儿先天性膈疝的X线及CT表现

目的 探讨先天性膈疝的影像学诊断价值.方法 回顾性分析13例经X线胸部平片、钡餐或钡灌肠造影及CT检查而诊断为先天性膈疝,其中8例经手术证实.结果 胸腹膜裂孔疝X线胸腹部平片表现为患侧胸腔内见含气肠襻,钡餐或钡灌肠造影显示小肠或结肠疝入胸腔内;食管裂孔疝X线胸腹部平片表现为心膈角处透亮影或无异常,钡餐显示胃疝入胸腔内或见三环征;胸骨后疝X线胸腹部平片表现为心膈角处见含气或无气肿块影,钡餐显示胃及小肠位置及形态正常,钡灌肠造影显示结肠疝入胸骨后方心膈角处.而CT二维重建成像均可显示膈肌缺损的大小、部位及疝入胸腔内的脏器形态.胸腹膜裂孔疝6例,食管裂孔疝5例,胸骨后疝2例,其中位于左侧10例,右侧3例.结论 联合合理运用影像学检查对婴幼儿先天性膈疝具有很高的诊断价值,为临床手术治疗提供重要的依据.     

儿童大肠扭转(病例分析和文献复习)

儿童年龄组大肠扭转罕见,迄今报导的共计30例。22例累及乙状结肠,8例累及右半结肠。皆基于X线检查包括腹部平片或辅以钡灌肠作出诊断。本文目的是通过分析、复习目前材料,增加对本病的领会。材料和方法:包括1959至1980年期间检治的女孩2例,男孩5例。发病年龄为3周至11岁。7例表现如急腹症,均作了腹部平片检查,其中5例还随后作了钡剂灌肠。症状和体征:大多数病人主诉为间歇性或持续性痉挛性腹痛,其次常见的症状为呕吐。所有病人在24小时内均有大便。发烧,腹胀各1例,从发病到确诊时间为3小时至7天。 X线表现:例1和例2腹部平片诊断为典型右     

新生儿十二指肠梗阻的X线诊断

目的探讨新生儿十二指肠梗阻的X线表现及鉴别诊断。方法回顾性分析52例经外科手术证实为十二指肠梗阻的X线资料,每例均行腹部直立位片检查,其中28例行上消化道泛影葡胺检查,36例行钡剂或泛影葡胺灌肠辅助检查。结果腹部直立片见“单泡征”9例,“双泡征”29例,“三泡征”6例,阶梯状多个短小气液平8例。上消化道造影检查显示十二指肠完全梗阻14例,不完全梗阻13例,其中显示空肠位置异常8例。结肠造影检查显示回盲部位置异常30例,伴细小结肠10例。52例中,肠旋转不良34例,十二指肠闭锁9例,十二指肠狭窄4例,环状胰腺5例。结论结合临床病史及腹部直立位片可对十二指肠梗阻做出诊断,鉴别诊断需做上消化道泛影葡胺造影和灌肠辅助检查。     

肠壁气囊肿症的影像学表现及病因病理探讨

目的：分析肠壁气囊肿症的影像学表现，探讨其形成机制及X线检查对其诊断的价值。材料与方法：选择7例经手术病理或综合影像学及临床随访证实的肠壁气囊肿症患者，采用腹部X线平片，SHIMADZU DAR-3000 DIGITEX PRO数字胃肠机及PICKER IQ～CT机检查。结果：立位腹平片可见膈下游离气体，间位小肠及串珠样囊状透亮区。消化道气钡双重造影可见胃窦溃疡，幽门梗阻及结肠内球形透亮充盈缺损，肠壁柔软。CT平扫可见胃壁十二指肠及小肠壁内线样透亮影。结论：X线检查在肠壁气囊肿症的鉴别诊断中有着不可替代的作用。     

成人先天性巨结肠的X线诊断

目的：探讨成人先天性巨结肠症的临床及X线的关系。材料与方法：回顾性分析5例先天性巨结肠的临床及X线表现并进行对照。结果：全部病例均有慢性便秘症状，X线表现与小儿先天性巨结肠病相仿，惟前者结肠狭窄段较短。结论：钡灌肠检查是成人先天性巨结肠的主要临床确诊方法，成人慢性便秘应首选钡灌肠检查，如显示出结肠边缘光滑的狭窄段及近段肠腔相应扩张，可考虑成人先天性巨结肠。     

消化道异物X线诊断

目的：提高消化道异物的X线诊断，减少误诊。方法：采用消化道气钡双重造影方法加点片及腹部平片对本科诊断13例消化道异物进行X线分析。结果：消化道异物有8例X线可透性异物及5例X线不透性异物两种。结论：消化道异物是一种常见病，X线检查是诊断该病的可靠方法之一。     

结肠脂肪瘤影像学诊断(附9例分析)

结肠脂肪瘤很少见,其临床症状不典型,X线钡灌肠及CT扫描是本病术前诊断的最佳检查手段。本文收集9例经X线钡灌肠、CT检查及手术病理证实的结肠脂肪瘤进行报道分析。1材料与方法本组9例患者,男1例,女8例,年龄为45~60岁,平均51岁。临床表现腹痛有9例,其中伴有呕吐2例,黏液性血便2例。体检腹部均有不同程度的压痛,5例扪及包块。9例均作常规X线钡灌肠,其中1例同时作CT平扫。2结果9结肠脂肪瘤位于黏膜下,回盲部5例、横结肠近段4例。X线钡灌肠表现:①充盈相均为肠腔内大小不等的卵圆形充盈缺损(图1),边缘光滑锐利7,轻度分叶状2例;②加压检查充…     

Diagnosis of tubular colonic duplication by barium follow-through study

Barium enema studies are considered essential for the diagnosis of tubular colonic duplication with opacification of two colons being the diagnostic sign. Yet in certain cases, barium enema apparently does not show positive findings. A case is reported in which a barium follow-through study established the complete diagnosis of duplication of colon and terminal ileum. The findings were confirmed on laparotomy.     

Endoluminal CT colonography after an incomplete endoscopic colonoscopy

OBJECTIVE: We evaluated the clinical usefulness of endoluminal CT colonography after an incomplete colonoscopy. SUBJECTS AND METHODS: We prospectively studied 40 patients in whom the cecum could not be reached endoscopically despite adequate bowel preparation. Endoluminal CT colonography (120 kVp, 120 mA, 3-mm collimation, pitch of 2, 1.5-mm interval reconstruction) was performed within 2 hr of incomplete colonoscopy. Two-dimensional multiplanar reformatted images and three-dimensional endoluminal images were analyzed. Twenty-six patients (65%) underwent barium enema immediately after endoluminal CT colonography. We analyzed colonic distention; duration of endoluminal CT colonography; patient tolerance; number of colonic segments seen at colonoscopy, endoluminal CT colonography, and barium enema; and reasons for incomplete colonoscopy as well as colonic and extracolonic findings. RESULTS: Duration of endoluminal CT colonography was 14.2 +/- 4.6 min (mean +/- SD). Endoluminal CT colonography was better tolerated than colonoscopy or barium enema (p < .001). Probable causes for incomplete colonoscopy were identified at endoluminal CT colonography in 74% of 40 patients. Baseline colonic distention in the region of the transverse and right colon was considered adequate before additional air insufflation; however, the addition of air significantly enhanced colonic distention throughout the entire colon (p < .001). Endoluminal CT colonography adequately revealed 96% of all colonic segments; in comparison, barium enema adequately revealed 91% of all segments (p < .05). CONCLUSION: In patients with incomplete colonoscopy, endoluminal CT colonography successfully showed the previously unrevealed colon in more than 90% of patients. Endoluminal CT colonography is a rapid, well-tolerated technique that provides clinically useful colonic and extracolonic information and should be considered for all patients who undergo incomplete colonoscopy.     

婴儿先天性巨结肠X线诊断

目的：探讨婴儿先天性巨结肠的Ｘ线特征及其检查方法。材料和方法：经手术及病理证实的１７例婴儿先天性巨结肠的Ｘ线表现与手术结果对照。结果：婴儿先天性巨结肠好发于直肠及乙状结肠的交界处。最典型的Ｘ线表现为狭窄、移行、扩张段并２４小时后均有不同程度的钡潴留。婴儿期先天性巨结肠的检查方法具有一定的特殊性。结论：Ｘ线检查是诊断婴儿先天性巨结肠的重要方法,绝大多数病例具有典型的表现。     

Radiological findings in total colon aganglionosis and allied disorders

OBJECTIVE: The aim of this study was to review the radiological findings of three cases of total colon aganglionosis (TCA), hypoganglionosis, and immature ganglionosis, and to compare the differences in diagnosis and follow-up of these three disease entities. MATERIALS AND METHODS: Three neonates with neonatal onset of abdominal distension with vomiting were investigated, and the cases were diagnosed as TCA, hypoganglionosis, and immature ganglionosis, respectively. Radiological examination of each neonate was performed during the neonatal period and at follow-up. RESULTS: A plain abdominal radiograph showed massive abdominal bowel gas and multiple air-fluid levels in all cases. Barium enema findings including no transition zone, normal rectosigmoid index, reflux of barium into a dilated ileum, and retention of barium on delayed film were observed in all three cases. In aganglionosis and hypoganglionosis, a normal-sized colon, irregular contraction, shortening of the colon, and lack of redundancy were observed. In immature ganglionosis, microcolon was present but there was no shortening of the colon or loss of redundancy. Barium studies following ileostomy during childhood revealed no efficient peristalsis after the neonatal period in patients with aganglionosis and hypoganglionosis. Conversely, the patient with immature ganglionosis showed maturity of colonic function on barium studies after infancy. CONCLUSION: The clinical and radiological findings of TCA and allied disorders are similar in neonates. Sequential contrast intestinal studies could reveal peristalsis of the colon wall, suggesting maturity of the ganglion cells.     

钡灌肠对结肠癌的X线诊断价值(附8例对照分析)

目的 钡灌肠是诊断大肠病变的最基本检查方法，结合文献复习探讨钡灌肠X线检查结肠癌的价值。方法 对8例钡灌肠患者进行回顾性分析，观察X线诊断大肠癌的可靠征象，分析钡灌肠的优势及局限性。结果 钡灌肠8例，结肠癌3例并与CT诊断、电子肠镜检查、手术所见对照。结论 钡灌肠对诊断大肠病变有其重要的价值。     

Diagnostic yield of barium enema examination after incomplete colonoscopy

PURPOSE: To determine the diagnostic yield of barium enema examination for neoplastic lesions larger than 1 cm in diameter in the nonvisualized portion of the colon after incomplete colonoscopy. MATERIALS AND METHODS: A review of computerized gastroenterology and radiology databases identified 355 patients who underwent incomplete colonoscopy; 158 (44.5%) underwent subsequent barium enema examination (125 double-contrast and 33 single-contrast barium enema examinations). The radiographic reports were reviewed and compared with the endoscopic reports by one author to identify neoplastic lesions larger than 1 cm in the nonvisualized colon after incomplete colonoscopy. Six such lesions were found. In all six cases, the images from the barium enema examinations were reviewed together by two authors to determine the size, location, and morphologic features (polypoid, ulcerated, or annular) of the lesions. Medical, endoscopic, and surgical records were subsequently reviewed by one author to determine whether these represented true- or false-positive radiographic findings. RESULTS: Barium enema examination depicted six possible lesions in the nonvisualized colon after incomplete colonoscopy; five were found to be true-positive radiographic findings, and one was found to be a false-positive finding. The five true-positive findings included two annular lesions (both adenocarcinomas) and three polypoid lesions (all tubulovillous adenomas, with high-grade dysplasia in one). Thus, neoplastic lesions larger than 1 cm were found on barium enema images in the nonvisualized colon in five (3.2%) of 158 patients after incomplete colonoscopy. CONCLUSION: Barium enema examination had a diagnostic yield of 3.2% for neoplastic lesions larger than 1 cm in the nonvisualized colon after incomplete colonoscopy.     

儿童克隆病的X线诊断

目的：探讨传统X线检查方法对儿童克隆病的诊断及其X线征象,以提高该病的X线检查诊断率,方法：28例行肠系钡餐和／或钡灌肠检查诊断为克隆病的患儿,经手术和病理学确诊13例,比较各种X线检查方法的诊断特异性及分析儿童克隆病的X线特征。结果：肠系钡餐对克隆病的诊断特异性为36．3％,钡灌肠为20．0％,两者联合应用诊断特异性显著提高达66．7％,儿童克隆病的X线特征易与肠结核,淋巴昆淆,结论：加强对和童克隆的重视,提高对X线征象的认识,以及联合应用肠系钡餐及钡灌肠检查方法将有助于克隆病诊断率的提高。     

成人先天性巨结肠症的X线表现与病理对照分析(附4例报告)

探讨成人先天性巨结肠症的临床、Ｘ线表现特点及其与病理的关系。材料与方法，回顾性分析４例ＡＨＤ的临床、Ｘ线表现并与病理学所见进行对照。结果全部病全 有慢性便秘症状、Ｘ线表现与小儿Ｈｉｒｓｃｈｐｒｕｎｇ’ｓ病相仿，惟前者结肠狭窄段较短。     

Small intestine ischemia simulating primary colonic disease

Clinical and radiographic findings were reviewed for four patients in whom colonic diverticulitis was suspected clinically but in whom small intestine ischemia was proved surgically. In each patient the initial diagnostic studies--plain abdominal radiography and barium enema examination--revealed generalized small intestine distention and non-specific colonic abnormalities, respectively. The latter findings consisted of an extrinsic impression on the superior or inferior aspect of the sigmoid colon with associated thumbprinting or spiculation. In each patient serosal inflammation of the sigmoid colon produced by an adherent segment of the ischemic small intestine was confirmed at laparotomy. In two patients, delay in surgical intervention resulted in small intestine necrosis. In a patient who has clinical signs and symptoms of colonic ischemia, diverticulitis, or small intestine obstruction but nonspecific findings on barium studies, the diagnosis of small intestine ischemia should be considered and further diagnostic imaging, such as angiography or small intestine follow-through examination, should be performed.