幽门狭窄的X线与超声诊断

目的:对比分析幽门狭窄的X线与B超的诊断价值。方法:50例患儿，全部经X线钡餐检查，部分做B超对比检查分析。结果:本组X线钡餐检查，均显示典型征象而被确诊。B超对照检查95％符合诊断标准。结论:X线钡餐与B超检查对幽门狭窄的诊断特异性都很高，X线检查以显示腔内形态结构，以及对瓣膜型狭窄的分型诊断优于B超。而对腔外幽门肌厚度大小及管壁周围相邻关系的显示B超胜过X线。     

超声与X线造影诊断婴儿肥厚性幽门狭窄的对比分析

目的比较超声和X线造影对婴儿肥厚性幽门狭窄(IHPS)的诊断价值。方法对61例临床疑诊IHPS的呕吐患儿进行超声和X线造影检查,结果进行统计学分析。结果与临床治疗结果比较,超声对IHPS的诊断符合率为95.08%,Youden指数89.31%,Kappa值0.875;X线造影对IHPS的诊断符合率为93.44%,Youden指数75.00%,Kappa值0.816。结论超声和X线造影诊断IHPS均较准确、可靠,超声检查更简便易行,可作为首选的影像学检查方法。当超声检查结果为阴性而患儿临床表现明显时,应结合X线造影结果,有利于及早明确诊断。     

婴幼儿先天性肥厚性幽门狭窄超声与X 线诊断的对比研究

目的　通过超声诊断CHPS 3 1例 ,与X线对照 ,讨论超声诊断的临床意义。方法　对X线诊断为CHPS的患儿进行超声检查 ,测量幽门管肌层厚度 ,观察胃潴留情况。结果　超声测量幽门横切面 ,幽门肌厚度≥ 3 .5mm ,合并胃潴留的3 1例患儿 ,诊断为CHPS ,与X线诊断相符合 ,并经手术证实。结论　超声可作为CHPS诊断的首选方法。     

二维超声和X线造影诊断先天性肥厚性幽门狭窄的比较

先天性肥厚性幽门狭窄是婴儿期常见的消化道畸形 ,本研究应用二维超声和Ｘ线造影对先天性肥厚性幽门狭窄分别诊断并将操作方法及结果比较 ,评价二维超声诊断价值。资料与方法本组患儿 45例 ,男 37例 ,女 8例 ,年龄 1 4～ 99ｄ 44例 ,2岁1例。患儿以频繁呕吐伴消瘦而就诊。应用ＴｏｓｈｉｂａＰＶ 80 0 0超声仪 ,5～ 1 1ＭＨｚ线阵变频探头。患儿取仰卧位 ,睡眠状态。探头置右肋缘下腹直肌外侧向内上斜切 ,以肝脏作透声窗 ,测量幽门管长径、肌层厚度、管腔内径。测值用 ｘ± ｓ表示。结　　果45例患儿 5例用二维超声单独诊断 ,30例由Ｘ线造…     

肥厚性幽门狭窄的B超检查技巧

肥厚性幽门狭窄(hypertrophic pyloric stenosis,HPS)是婴儿常见的消化道疾病之一,既往依靠临床和X线钡餐检查而诊断.近年我们将B超应用于HPS的检查、诊断,收到较好效果,现将B超检查技术及体会报道如下.     

先天性肥厚性幽门狭窄的超声诊断价值

目的 通过总结手术证实的57例先天性肥厚性幽门狭窄（CHPS）的超声诊断结果,探讨该病的声像图特点及临床应用价值.方法 测量幽门管长度,直径及幽门肌厚度.结果 57例CHPS的幽门肌厚度均≥3.5 mm,最厚8.5 mm,平均4.7 mm.结论 超声可作为诊断CHPS的首选方法.     

超声诊断婴幼儿先天性肥厚性幽门狭窄

目的：通过14年应用超声诊断先天性肥厚性幽门狭窄（CHPS）96例，回顾其临床应用价值。方法：对患儿的幽门管肌层厚进行测量，与22例正常婴儿进行比较，观察胃内容物滞留情况，结果：超声测量幽门横切面幽门肌厚度≥3.5mm，合并胃潴留的90例患儿，诊断为CHPS，并经手术证实，结论：超声可作为诊断CHPS首有选方法。     

先天性肥厚性幽门狭窄的影像学诊断

先天性肥厚性幽门狭窄(CHPS)是新生儿期常见的疾病;患儿呕吐频繁,摄入量不足可造成慢性脱水、电解质紊乱和营养不良,及时诊断,手术治疗可痊愈.本文搜集78例持续性呕吐疑诊CHPS患儿,观察CHPS的彩色多普勒超声和钡餐造影的影像表现,以提高对本病的认识.     

高频超声诊断先天性肥厚性幽门狭窄

先天性肥厚性幽门狭窄,是新生儿常见的外科疾病。男婴发病率明显高于女婴。就诊时间多在1～2月问。我院近一年来应用高频超声诊断9例先天性肥厚性幽门狭窄患儿,均经手术病理证实,现报道如下。     

高频超声与X线钡剂造影对先天性肥厚性幽门狭窄诊断及分型的价值

目的 探讨高频超声与X线钡剂造影对先天性肥厚性幽门狭窄(CHPS)诊断与分型诊断的价值.方法 对以呕吐为主要症状的患儿常规进行高频超声和X线钡剂造影检查,并将两种检查方法加以对照.对经手术证实、资料完整的29例病例进行回顾性分析.正常组选取健康新生儿20例,并对其正常测值与CHPS组进行对比.结果 29例CHPS,超声诊断符合率100%,X线诊断符合率93.1%(27/29).CHPS组超声测量幽门管的长度均≥18 mm,幽门管直径≥14 mm,幽门管壁厚度≥4 mm,狭窄的管腔径均≤6 mm;X线测量幽门管长≥20 mm,管腔径≤7 mm,与正常组比较差异均有统计学意义(P＜0.01).根据幽门管腔狭窄和管壁增厚程度的影像表现,将CHPS分为轻型(Ⅰ)和重型(Ⅱ)两类,若4 mm≤幽门管壁厚≤6 mm,幽门管腔径＞3 mm为轻型;幽门管壁厚＞6 mm,幽门管腔径≤3 mm或呈闭塞状为重型.结论 CHPS的超声分型诊断具有一定的临床价值;高频超声对CHPS的诊断简便易行、准确可靠,避免了患儿吞钡和X线照射及减少吸人性肺炎的危险.     

高频超声诊断婴幼儿先天性肥厚性幽门狭窄的应用价值

目的:探讨高频超声在诊断婴幼儿先天性肥厚性幽门狭窄(C H P S)的临床应用价值.方法:回顾性分析我院收治的11例怀疑先天性肥厚性幽门狭窄患儿的超声表现,观察胃潴留情况、胃内容物通过幽门管情况、幽门管形态,测量幽门肌层厚度、幽门管直径、幽门管长度.结果:11例患儿均为足月儿,均为进行性呕吐加重,1例经内科治疗后好转,...     

Feasibility of emergency physician diagnosis of hypertrophic pyloric stenosis using point-of-care ultrasound: a multi-center case series

Hypertrophic pyloric stenosis (HPS) is an acute abdominal emergency in infants that often presents to Emergency Departments. The clinical diagnosis of HPS relies on palpation of an olive-sized mass in the right upper quadrant of an infant with a history of projectile vomiting. However, studies have shown that clinicians cannot detect the olive in 11% to 51% of cases. Ultrasonography is the imaging modality of choice to diagnose HPS. HPS has a highly characteristic sonographic appearance that makes it readily identifiable on ultrasound. To our knowledge, there have been no reports documenting the ability of Emergency Physicians to diagnose HPS using point-of-care ultrasound. We present a multi-center case series (n = 8) of HPS diagnosed by Emergency Physician-performed ultrasound. We review the technique of incorporating point-of-care ultrasound into the physical examination of infants with suspected HPS and discuss the possible role of point-of-care ultrasound in the management of these patients.     

Pylorus subjacent to the gallbladder: An additional finding in hypertrophic pyloric stenosis

We have noted that sonographically positive cases of hypertrophic pyloric stenosis (HPS) demonstrate a distortion of normal anatomy in which the elongated pylorus displaces the duodenum and lies adjacent to and below the gallbladder. Ten consecutive cases of HPS diagnosed by ultrasound were reviewed. In each case the pylorus was imaged subjacent to the gallbladder. Sonograms from 100 infants from a different institution were then reviewed. There were 13 cases with the pylorus subjacent to the gallbladder, 12 of these met criteria for HPS. Recognition of this anatomic relationship may aid in the diagnosis of HPS. © 1995 John Wiley & Sons, Inc.     

Ultrasound in the diagnosis of hypertrophic pyloric stenosis

Abdominal B-scan ultrasound imaging was performed on 35 infants who presented with vomiting. A thick hypoechoic ring was visualized in 21 of the 23 patients found at surgery to have hypertrophic pyloric stenosis. The ring was shown to represent the hypertrophied circular muscle of the pylorus. Each side of the ring measured 4 mm or more in thickness in the positive studies. None of the patients without hypertrophic pyloric stenosis showed this finding, although thinner hypoechoic rings were often seen, representing parasagittal sections of distal antral muscle.     

Ultrasound diagnosis of evolving pyloric stenosis

Two infants with recurrent episodes of vomiting had upper gastrointestinal barium studies that did not show radiographic features of pyloric stenosis. However, follow-up abdominal sonograms done 1–2 weeks later documented hypertrophic pyloric stenosis, which led to surgery. This entity is not congenital, but an evolving acquired lesion. Therefore, ultrasound is an excellent modality to evaluate and monitor patients clinically suspected of developing hypertrophic pyloric stenosis despite their initially negative imaging studies.     

Chronic gastric volvulus and hypertrophic pyloric stenosis in an infant

Chronic secondary mesenteroaxial gastric volvulus associated with hypertrophic pyloric stenosis has rarely been mentioned in the general medical literature. We report the case of a 2-month-old boy whose clinical symptoms, which included distension of the stomach and projectile vomiting, suggested the diagnosis of hypertrophic pyloric stenosis but who was later diagnosed with chronic secondary mesenteroaxial gastric volvulus. Sonographic examination revealed findings consistent with a rotated stomach, and subsequent plain chest radiography demonstrated a left diaphragmatic eventration. An upper gastrointestinal series radiographic examination with barium contrast enhancement confirmed the diagnosis of mesenteroaxial gastric volvulus. Surgery was performed, and the boy recovered well. A follow-up sonographic examination performed 3 months post-operatively revealed no abnormalities. This case demonstrates that primary or secondary gastric volvulus, although rare in children, should be considered in the differential diagnosis of pediatric patients with a history of vomiting.     

Long-term analysis of ultrasonic features of the antropyloric region 17–27 years after treatment of infantile hypertrophic pyloric stenosis

Long-term follow-up was performed 17 years to 27 years after conservative (n = 12) and operative (n = 36) treatment in 48 patients with infantile hypertrophic pyloric stenosis (IHPS). The follow-up examination included an interview to define any existing gastrointestinal symptoms and to determine whether a current disorder of the gastrointestinal tract was present; a clinical examination, including a scintigraphic determination of gastric emptying; as well as—for the first time—abdominal sonography emphasizing the antropyloric region. The sonographical examination included measurements of pyloric diameter and length, as well as wall and muscle thickness in the antropyloric region. The results were compared with data from a control group with the same age and gender distribution. No association was found between the sonographic parameters obtained, reported gastrointestinal symptoms, or altered gastric emptying times for solids and liquids. Clinically relevant disorders of stomach motility after IHPS appear to be a rare occurrence. © 1994 John Wiley & Sons, Inc.     

高频超声在婴幼儿先天性肥厚性幽门狭窄诊断中的应用

目的探讨高频超声在先天性肥厚性幽门狭窄（ＣＨＰＳ）中的应用价值。方法对３０例ＣＨＰＳ患儿的幽门管长度、厚度及幽门肌层厚度进行测量,并与手术结果及１０例正常婴儿进行比较。结果超声测量ＣＨＰＳ幽门管长度≥１５ｍｍ,幽门管厚度≥１０ｍｍ,幽门肌层厚度≥４ｍｍ,与正常婴儿比较均有显著性差异（Ｐ〈０．０１）,超声测量ＣＨＰＳ患儿幽门管厚度和幽门肌层厚度与手术中测量无显著性差异（Ｐ〉０．０５）。结论高频超声对     

Ultrasonographic serial measurements of the morphologic resolution of the pylorus after Ramstedt pyloromyotomy for infantile hypertrophic pyloric stenosis.

OBJECTIVE: The purposes of this study were to evaluate the accuracy of the ultrasonographic measurements used during diagnosis of hypertrophic pyloric stenosis (HPS), to examine the relationship between the palpability and the morphologic features of the pyloric mass, and to show the morphologic resolution of the pylorus after pyloromyotomy. METHODS: One hundred three infants with the diagnosis of HPS by clinical findings and ultrasonographic measurements were treated surgically by Ramstedt pyloromyotomy. The measurement parameters were the muscle thickness, diameter, and channel length of the pylorus. The serial measurements were performed postoperatively for 1 year after surgery. RESULTS: The preoperative ultrasonographic measurements of the pylorus were significantly correlated with the actual measurements obtained by surgery (P<.05). The diameter correlated most significantly with the palpability of the pylorus. In contrast to the prompt improvement of clinical symptoms, the muscle thickness did not reach the normal range (approximately 2 mm) until 8 months after surgery. The diameter had not decreased to its normal range (approximately 10 mm) by the end of the 1-year postoperative follow up period. The channel length decreased more rapidly than the other 2 parameters. CONCLUSIONS: The preoperative ultrasonographic measurements of the pylorus reliably evaluated the pyloric muscle thickness and diameter in HPS. The actual pyloric diameter correlated with the palpability of the pyloric mass. The morphologic resolution of the pylorus after surgery did not correlate with the prompt improvement of symptoms.