彩色多普勒超声对结核性腹膜炎的诊断价值

目的评价彩色多普勒超声诊断结核性腹膜炎的临床实用性,提高对该病早期诊断的临床水平。方法用彩色超声诊断仪,含有低频(3.5～5.0 MHz)、高频(7.5～10.0 MHz)及彩色血流显像、多普勒频谱等功能,综合检查126例结核性腹膜炎患者。结果彩色超声诊断符合率88.1%(111例),其中超声检出腹水无回声区117例(92.8%),腹膜增厚(包括肠壁、大网膜增厚)104例(82.5%),淋巴结肿大78例(61.9%),实质性团块35例(27.8%),包裹性积液8例(6.3%)。结论彩色多普勒超声可作为结核性腹膜炎的首选检查方法。     

回盲部淋巴瘤超声表现1例

患者女,43岁,因右下腹疼痛在外院诊断为阑尾炎,抗炎治疗10d,未见好转,转来我院就诊。体格检查:右下腹可触及索条状包块,压痛及反跳痛明显;实验室检查:白细胞4.5×109/L;既往有柏油便史。超声检查:沿结肠至回盲部扫查,见回肠末端肠壁全周有明显不规则增厚,横切面呈"靶环征",病变肠壁最厚处达3.1cm,长度约6.7cm,回盲部蠕动僵直。彩色多普勒血流成像示:增厚肠壁内见丰富的血流信号,呈线状或树枝状(图1),     

儿童腹型过敏性紫癜的彩色多普勒超声诊断分析

目的探讨彩色多普勒超声诊断儿童腹型过敏性紫癜肠道损害的价值。方法运用彩色多普勒超声对21例急腹症患儿进行腹部及肠道超声检查,观察肠道损害部位、形态及回声变化特点。结果21例患儿在皮肤淤斑出现之前均经彩色多普勒超声检查发现肠道损害变化:(1)病变部位以小肠为主;(2)肠管节段性扩张,肠壁增厚,黏膜粗糙,肠腔狭窄;(3)增厚肠壁血流丰富。结论彩色多普勒超声对儿童腹型过敏性紫癜的早期诊断及鉴别诊断有重要价值。     

高频超声和彩色多普勒超声在诊断腹型过敏性紫癜中的价值

目的探讨高频超声和彩色多普勒超声在腹型过敏性紫癜中的诊断价值。方法运用高频超声和彩色多普勒超声对25例急腹症患儿进行腹部肠道超声检查，观察受损肠壁回声、厚度，测量受损肠壁的彩色血流的速度及阻力指数。结果25例超声诊断为腹型过敏性紫癜的患儿经临床、实验室、内镜检查确诊为腹型过敏性紫癜的有24例。超声诊断符合率为96％，其受损肠壁声像特点：1．肠壁单发或多发性、节段性增厚；2．增厚肠壁血流丰富；3．增厚肠壁的血流速度及阻力指数（RI）均较正常稍有下降。结论高频超声及彩色多普勒超声在儿童腹型过敏性紫癜的早期诊断及鉴别诊断起重要作用。     

超声诊断急性缺血性肠坏死

本文通过对 5例急性缺血性肠坏死超声表现回顾 ,旨在交流急性缺血性肠坏死的声像图表现。资料与方法本组病例中 ,男性 2例 ,女性 3例。最小年龄 3 7岁 ,最大年龄 80岁 ,平均 5 9岁。全部患者均以腹痛就诊 ,全腹压痛 ,反跳痛 ;3例白细胞总数升高 ;2例门诊急诊 ,3例住院期间腹痛就诊 ,3例患者伴有心房纤颤 ,合并冠心 1例 ,剖腹产后腹腔感染1例。仪器使用EUB -5 2 5彩色多普勒超声诊断仪 ,3 .5MHz凸阵探头 ,平卧位经腹扫查 ,肠气较多时适当加压探头。发现病变肠管 ,记录肠壁增厚程度及范围 ;加彩色检查病变段肠管有无血流信号 ,并仔细检查病…     

自然组织谐波和彩色多普勒超声对成人肠套叠的诊断价值

目的探讨自然组织谐波结合彩色多普勒超声诊断成人肠套叠的实用价值.方法使用3.5 MHz和8.0MHz探头对22例因腹部疼痛或包块的患者,做二维基波、自然组织谐波和彩色多普勒超声检查,分析肠套叠的声像图特征,套叠类型及病因.结果 22例经手术和病理证实.全部资料超声图像典型,超声定位符合率为95.5%(21/22),超声对病因的发现率为90.9%(20/22).其中小肠-小肠型7例,回肠-结肠型8例,结肠-结肠型7例.手术病理证实为肠道脂肪瘤4例,小肠间质瘤1例,肠道血管瘤2例,炎性纤维样息肉2例,Peutz-Jeghers型错构瘤性息肉2例,肠道淋巴瘤2例,肠癌6例,盲肠炎症1例,血友病肠壁血肿1例,Meckel's憩室1例.结论自然组织谐波较基波能更清晰地显示病变,彩色多普勒超声对判断套叠肠管的缺血有重要帮助,超声在发现肿瘤等病因上有较高敏感性.     

小肠间质瘤超声表现1例

患者男,73岁,常规超声检查:于盆腔膀胱右上方可见一大小约6.3cm×4.5cm×5.8cm弱回声块影,边界清晰,形态呈球形,内部回声尚均匀,后方回声增强。其右侧缘起源于一小肠壁,该段肠壁明显增厚,回声减低,呈"假肾征",中央可见气体亮带。彩色多普勒血流成像:丰富血流信号自增厚小肠管壁向弱回声块影实质内延伸(图1)。脉冲多普勒:弱回声块影内测得     

彩色多普勒超声对腺性膀胱炎的声像图分型及诊断价值

目的探讨彩色多普勒超声对腺性膀胱炎的临床诊断价值。方法对39例腺性膀胱炎患者,采用彩色多普勒超声观察病变的位置、形态、边界、内部回声及病变与膀胱壁的关系,并应用彩色多普勒血流成像观察病变边缘及内部的血流分布,同时将其声像图表现进行分型。对比分析超声检查与膀胱镜活检或手术病理诊断结果。结果声像图表现分为囊状结节型5例、实体结节型8例、局部壁增厚型21例,弥漫性壁增厚型5例,59．0％（23／39）的病变位于膀胱三角区及尿道内口周围,69．2％（27／39）的病变内部见小囊状无回声区。彩色多普勒超声检查诊断腺性膀胱炎的准确率达84．6％（33／39）。结论彩色多普勒超声检查能清晰显示腺性膀胱炎病变的位置、边界、形态、内部回声及病变与膀胱壁的关系,对腺性膀胱炎的诊断、鉴别诊断和临床随访有重要作用。     

彩色多普勒超声检查在老年人结肠癌的应用价值

目的探讨彩色多普勒超声检查对老年人结肠癌诊断的临床应用价值。方法回顾性分析应用彩色多普勒超声对52例诊断为结肠癌的老年患者,将其结果与手术病理对照分析。结果彩色多普勒超声检查与病理定性诊断符合50例(96.2%),定位诊断与病理符合46例(88.5%),瘤体内部均显示粗细不等的动脉血流信号(检出率100.0%),同时,彩色多普勒超声检查能较准确地对腹腔淋巴结的转移、肝转移、外生型肿瘤侵及周围组织做出诊断,符合率分别为90.0%、100.0%、77.8%。结论彩色多普勒超声检查根据肠壁局限性及弥漫性增厚及肿瘤内血流及血流动力学的表现诊断结肠癌,可作为老年人结肠癌筛查的首选方法,对诊治提供了更可靠的依据,具有重要的临床意义,可作为老年人结肠癌诊断的一项无创性检查方法。     

多层螺旋CT在溃疡性结肠炎中的应用

回顾性分析2011年1月-2012年1月在我院治疗的96例溃疡性结肠炎患者的治疗资料,所有患者均进行多层螺旋CT平扫和双期增强扫描。结果常规窗宽窗位显示黏膜强化84例,黏膜气下泡影8例,肠壁增厚96例,肠壁水肿分层72例;改良后窗宽窗位显示黏膜强化4例,黏膜气下泡影64例,肠壁增厚96例,肠壁水肿分层6例;多平面重组图像显示病变范围,全结肠者8例,左半结肠者20例,横结肠10例,直肠和乙状结肠者62例。肠壁水肿分层、结肠壁增厚等临床CT诊断结肠炎敏感性较高,黏膜强化、黏膜气泡影诊断UC（溃疡性结肠炎）特异性较高,使用不同窗宽窗位和MPR图像利于UC诊断及显示病变范围。     

肠系膜血管病的超声诊断

目的 应用彩色多普勒超声诊断肠系膜血管病，并总结其声像图特征。方法 18例腹痛患者急诊行超声检查，应用高频探头测量小肠壁的厚度、病变范围、肠壁回声、肠蠕动状况、肠壁和肠系膜血流等。结果 肠系膜血管病18例中，超声诊断动脉性缺血14例，超声诊断符合率85．7％(12／14)；静脉性缺血4例，超声诊断符合率75．0％(3／4)。全部病例经手术证实，超声诊断符合率83．3％(15／18)，假阳性2例(11．1％)，假阴性1例(5．6％)。结论 超声检查可通过直接征象确定该病的诊断，并可判断肠系膜血管栓塞的类别、范围，是肠系膜血管病首选的检查方法。     

超声对原发性肠脂垂炎的检查价值

目的 探索超声对原发性肠脂垂炎的检查价值.方法 回顾性分析37例经随访证实的原发性肠脂垂炎的超声表现,观察病变部位、内部回声、大小、边界及血流分布.结果 37例原发性肠脂垂炎均发生于结肠侧旁,其中位于盲肠周围3例,升结肠周围4例,降结肠周围4例,乙状结肠周围26例.超声声像图特征表现为偏高回声包块,呈倒三角形或椭圆型,边界欠清,平均长径(3.9±0.9) cm,平均厚度(2.3±0.8) cm,彩色多普勒包块内未发现明显的血流信号,部分病例周边可见少量血流信号.结论 原发性肠脂垂炎超声表现有其特征性,结合临床表现容易作出提示诊断.     

Color Duplex evaluation of the mesenteric artery

Ischemic colitis is the most common form of intestinal ischemia. Diagnosis is made at clinical examination and endoscopy and completed by vascular imaging, but color Doppler US may become a first-line imaging technique for the evaluation of the mesenteric circulation.We present the case of an 80-year-old woman hospitalized for recurrent ischemic colitis of the sigmoid. At a previous hospitalization, color Doppler US examination showed medium to severe stenosis at the origin of the inferior mesenteric artery. However, CT angiography was negative and the condition was therefore misdiagnosed. Eight months later the patient was admitted again with abdominal pain and rectal hemorrhage. Rectosigmoidoscopy documented the presence of ischemia of the sigmoid mucosa. Angiography showed the presence of severe stenosis at the origin of the inferior mesenteric artery so revascularization was carried out by percutaneous transluminal angioplasty (PTA) during the same session. Follow-up showed normal patency of the inferior mesenteric artery after revascularization, and subsequent endoscopic evaluation documented gradual colonic mucosal ischemia resolution. Blood flow at the level of the inferior mesenteric artery was assessed using color Doppler US. The presented case confirms that color Doppler US is a valid first-line imaging technique in the assessment of ischemic intestinal lesions. It is reliable in the evaluation of the mesenteric arterial circulation, and it also allows assessment of blood flow alterations caused by stenosis and identification of localized hemodynamic stenosis which may be missed at CT-angiography or MR-angiography. Arteriography remains the examination of choice in case of discrepancy between first-and second-line imaging techniques and in all cases which offer the possibility of endovascular revascularization.     

彩色多普勒超声检查在缺血性肠病诊断中的价值

目的探讨彩色多普勒超声在缺血性肠病中的表现及其在诊断中的价值。方法对78例确诊为缺血性肠病的超声表现与临床资料进行回顾性分析。结果 78例全部经手术病理或组织活检病理或数字减影血管造影技术（digital subtraction angiography,DSA）检查确诊为缺血性肠炎,超声显示肠壁增厚或肠系膜上动脉狭窄共62例,此直接征象预测缺血性肠炎的阳性率79.5%（62/78）;56例显示壁间血流信号消失或很难显示,提示缺血性肠炎的阳性率90.3%（56/62）。结论超声检查廉价、无创、迅速,对缺血性肠病有较高的检出率且定位较明确,可作为本病的影像学首选检查方法。     

Phlebosclerotic colitis: three cases and literature review

Three cases of phlebosclerotic colitis (PC) are presented and all in males. The etiology of the PC still remains unknown. The characteristic manifestations of PC were transmural calcifications on CT and dark purple mucosa on endoscopy. Cases 1 and 2 underwent computed tomography (CT), magnetic resonance imaging (MRI), and endoscopy while case 3 underwent CT and endoscopy. Cases 1 and 2 were admitted to our hospital for ileus. Case 3 had been diagnosed as ischemic colitis and came to our hospital for re-examination. Calcifications could be found within the colon wall and adjacent mesenteric vein from cecum to transverse colon in case 1 and from cecum to descending colon in cases 2 and 3. Extensive mural thickening of the colon could be seen on CT imaging and MRI, while dark purple mucosa was found on endoscopy in all three patients. However, their extents were more than those of calcifications. The literature is limited to a few case reports. Clinicians should be familiar with the imaging and endoscopy features of PC and radiologists should pay attention to the thickening of colon wall beside the calcifications.     

肝脏实性占位病变超声诊断的临床研究

目的 :探讨肝脏实性占位病变尤其是≤ 3cm的小肝癌应用二维超声和彩色多普勒的诊断价值。方法 :采用 Medison- 880 0及 Toshiba- 35 0彩色多普勒超声诊断仪 ,探头频率为 3.5 MHz,对 16 8个肝脏实性占位病变进行检查 ,并与超声引导下细针穿刺活检所得病理结果对照。结果 :16 8个肝脏实性占位病变中 ,肝细胞肝癌和肝转移癌占 72 % (12 1/ 16 8) ;32个≤ 3cm肝脏占位病变中 ,肝细胞肝癌和肝转移癌占 5 3% (17/ 32 )。结论 :彩色多普勒超声检查可提高肝脏占位病变的诊断 ,对病灶性质存有异议时可行超声引导下穿刺活检     

基波、自然谐波和彩色多普勒超声对急性阑尾炎的诊断价值

目的探讨二维基波和自然谐波条件下,结合彩色多普勒超声在急性阑尾炎检查中的实用价值。方法对166例因腹部疼痛或可疑阑尾炎的患者,分别在二维基波、自然组织谐波和彩色多普勒超声条件下,使用7.0～10.0MHz高频和3.5～4.0MHz普通腹部探头做超声检查,分析阑尾区的图像特点,对比不同频率的探头对于阑尾显示的效果。结果全部病例经手术、病理或治疗后随访观察证实。166例病例中,超声确诊急性阑尾炎136例(81.9%),急性阑尾炎合并周围脓肿或炎性包块30例(18.1%),急性阑尾炎的彩色血流信号显示率62.0%。结论高频超声在显示肿大阑尾结构上更具有特异性,能明显提高肿大阑尾的显示率。彩色多普勒血流有助于急性阑尾炎的诊断。二维基波、自然谐波和彩色多普勒超声检查可作为临床诊断急性阑尾炎的重要依据。     

Application of color Doppler ultrasonography to ulcerative colitis

We used color Doppler ultrasonography (US) to evaluate bowel wall thickening in ulcerative colitis and to determine the value of this modality in this application. Twelve patients (6 men and 6 women) with ulcerative colitis underwent both gray-scale and color Doppler US. Bowel wall thickness and wall echotexture were recorded by gray-scale US, and the presence of intramural color Doppler flow and arterial signal were evaluated by color Doppler US. Color Doppler flow was graded as ‘weak’ or ‘abundant’, and resistive index was calculated; clinical severity of disease activity was also graded, and serum CRP level was measured. Variation in serum CRP levels and intramural color Doppler flow according to clinical severity, and the correlations between serum CRP levels and the number of blood flow signals were statistically significant. In 10 of the 12 patients, analysis of the Doppler waveform showed an arterial blood flow signal, and mean resistive index value was determined to be 0.550. We thus conclude that information provided by gray-scale and color Doppler US is useful in evaluating bowel wall thickening in ulcerative colitis.     

Gray-scale and power doppler sonographic appearances of acute inflammatory diseases of the scrotum

PURPOSE: We describe the spectrum of gray-scale and power Doppler sonographic appearances in inflammatory scrotal diseases. METHODS: Twenty-five patients ranging in age from 3 to 69 years underwent gray-scale and power Doppler sonography with multifrequency transducers of 7-9 MHz or 10-13 MHz. In addition, color Doppler and power Doppler findings were compared in 7 cases. RESULTS: In all 5 prepubertal patients, power Doppler imaging demonstrated hyperemia associated with epididymitis and, in some cases, orchitis. Among the 20 pubertal and adult patients, power Doppler imaging revealed increased vascularity associated with spermatic cord involvement, epididymitis, orchiepididymitis, or orchitis. Enlargement and heterogeneity of the epididymis and/or testis were seen in 11 patients, with vas efferens ectasia in 3 patients. Abscess formation and testicular infarction were easily depicted by power Doppler imaging. In 5 cases total, hyperemia was the only sonographic finding of inflammation. In the comparison between color and power Doppler imaging, a subjective increase in the number and length of vessels was seen with power Doppler imaging. CONCLUSIONS: Power Doppler imaging is an easy and fast Doppler modality for evaluating inflammatory conditions of the scrotum and proved especially useful in cases with no gray-scale sonographic anomalies, in prepubertal patients, and in patients with abscesses or ischemic lesions.     

彩色多普勒超声对腹壁瘢痕子宫内膜异位症的诊断价值

目的探讨腹壁瘢痕子宫内膜异位症的二维及彩色多普勒超声特征.方法对7例经手术及病理证实的腹壁瘢痕子宫内膜异位症的超声图像进行回顾性分析.结果腹壁瘢痕处探及边界不清、形态不规则、内部不均质的低回声肿块,彩色多普勒血流显示肿块周边部血流信号丰富,多普勒频谱表现为低速高阻的特点,PSV 6.5～19 cm/s,RI 0.71～0.85.结论彩色多普勒超声有助于对腹壁瘢痕子宫内膜异位症的诊断与鉴别诊断.