大网膜转移癌的超声诊断探讨

目的：探讨大网膜转移癌的超声诊断价值。方法：观察33例经手术或穿刺活检病理证实的大网膜转移癌的二维图像及血流特点。结果：（1）大网膜转移癌可见网膜弥漫性增厚和局限性增厚，以局限性增厚为主（72．7％），主要位于上腹部，右侧腹，左侧腹；（2）内部回声呈中等回声者23例，其中12例伴低回声结节，呈低回声者10例，4例伴结节；（3）彩色血流显示率2级以上为60．6％；（4）33例大网膜转移癌同时伴网膜外转移的占27．3％。结论：超声检查大网膜是发现腹腔脏器恶性肿瘤有无腹腔转移的最直接，最敏感的方法。     

大网膜转移癌的超声诊断价值

目的探讨大网膜转移癌的超声诊断价值。方法分析50例大网膜转移癌的超声表现。结果50例患者中,弥漫性增厚20例,其中10例伴有低回声结节;局限性增厚27例,其中15例伴有低回声结节,1例表现为孤立性结节;漏诊3例。结论超声对判断大网膜转移癌的部位及内部结构具有临床价值。     

大网膜转移癌的超声诊断探讨种

目的探讨大网膜转移癌的超声诊断价值.方法观察33例经手术或穿刺活检病理证实的大网膜转移癌的二维图像及血流特点.结果①大网膜转移癌可见网膜弥漫性增厚和局限性增厚,以局限性增厚为主(72.7%),主要位于上腹部、右侧腹、左侧腹;②内部回声呈中等回声者23例,其中12例伴低回声结节,呈低回声者10例,4例伴结节;③彩色血流显示率2级以上为60.6%;④33例大网膜转移癌同时伴网膜外转移的占27.3%.结论超声检查大网膜是发现腹腔脏器恶性肿瘤有无腹腔转移的最直接、最敏感的方法.     

大网膜病变的超声表现

目的评价大网膜病变的超声诊断价值。积累大网膜病变的超声诊断经验。 方法回顾性分析经病理学证实或临床治疗观察确诊的152例大网膜病变的超声改变。 结果病变大网膜的声像图特征：急性炎症多表现为增厚大网膜边缘锐利、清晰,内部回声略增强,原发性炎症仅与壁层腹膜粘连,继发性炎症邻近原发病灶。原发性肿瘤多表现为椭圆形或分叶状不均匀低回声肿块。结核性增厚的大网膜多呈饼状,回声高低间杂。转移性大网膜增厚多呈不规则结节状,回声中等或较低,并伴有低回声结节,CDFI能显示结节内血流信号。 结论超声医师能够根据大网膜改变的声像图特点,判定大部分病变的性质。当不能确定时,可在超声引导下穿刺活检确认。     

儿童肠系膜囊肿及继发病变超声表现

目的总结儿童肠系膜囊肿及继发病变超声表现,评价超声诊断儿童肠系膜囊肿及继发病变的价值。方法对2005年1月至2010年12月我院收治的经手术及病理证实的41例肠系膜囊肿患儿超声表现和手术所见进行对比分析。结果本组41例肠系膜囊肿患儿共42个病灶,其中单发40例,多发1例。42个肠系膜囊肿病灶中,超声呈单房囊性(4个)或多房囊性(37个)包块;肠系膜囊肿超声声像图表现为形态规则的单房囊性团块或边缘不规则、囊腔大小不一、形态不一的多房囊性团块,囊内回声因成分不同而不同。本组8例肠系膜囊肿患儿继发出血,超声检查示出血囊腔张力增高、透声减低;6例患儿肠系膜囊肿及肠扭转并肠梗阻,超声检查可见肠管积液扩张及扭转肠系膜的"集束征"或"漩涡征";4例患儿继发感染,超声检查示囊肿壁增厚、周围见低回声索条。本组41例肠系膜囊肿患儿42个病灶术前超声诊断正确39个,超声诊断符合率92.9%(39/42),术前超声误诊3个,分别误诊为大网膜囊肿1个、肠重复畸形1个、肠系膜淋巴血管瘤1个;本组肠系膜囊肿合并症诊断符合率为66.7%(12/18),术前超声漏诊6例,分别为出血3例、肠梗阻1例、感染2例。结论超声检查对儿童肠系膜囊肿可作出定性诊断,对其并发症诊断也有很高的价值。超声检查应作为儿童肠系膜囊肿首选影像学检查方法 。     

1例罕见儿童原发性大网膜扭转误诊急性阑尾炎行腹腔镜检查的围手术期护理

目的 探讨腹腔镜手术治疗儿童原发性大网膜扭转误诊急性阑尾炎的方法、优点及护理措施.方法 分析1例术前误诊急性阑尾炎行腹腔镜探查,明确诊断,术中发现原发性大网膜扭转坏死采取相应手术及护理措施,特别是对患儿实施全方位围手术期护理：术前重视病情观察及心理疏导;做好皮肤护理尤其是脐部清洁,它直接影响切口的愈合;术后护理重点观察生命体征的变化及腹部伤口情况;加强各种引流管的护理,做好预防并发症观察及护理和出院健康指导.结果 患者经腹腔镜探查证实为大网膜扭转坏死,切除坏死大网膜,术后5d痊愈出院,术后随访6个月无不适.结论 原发性大网膜扭转缺少特异性临床表现,术前易误诊.腹腔镜手术在诊治原发性大网膜扭转中具有优势,值得在临床推广.精心细致的护理是手术成功的重要保障.     

双频超声对大网膜结核的诊断价值

目的 :探讨大网膜结核的声像图表现 ,以提高结核性腹膜炎的超声诊断水平。方法 :用低频和高频超声对 43例经病理证实的大网膜结核患者网膜回声特点进行观察。结果 :1.大网膜结核内部回声可以分为 3种类型 :高回声型、高低回声间杂型 (高频超声呈“大脑沟回”状 )、结节型 ,其中“大脑沟回”状改变为大网膜结核的特征性声像图表现 ;2 .对大网膜病变内部回声的观察 ,高频超声明显优于低频超声。结论 :高频超声检查有助于大网膜结核的诊断     

腹膜假性黏液瘤的超声表现与手术病理对照分析

目的 通过比较腹膜假性黏液瘤(PMP)超声表现与手术探查所见,探讨超声在检查PMP中的诊断价值.方法 对22例手术和/或超声引导下穿刺活检病理证实为PMP患者的声像图表现和外科手术病理结果 进行回顾性分析及比较.结果 22 例中术前超声检查提示PMP 21例,漏诊1例,诊断准确率95.5%.超声分型表现:以腹水表现为主8例,以腹膜增厚表现为主伴腹水14例(7例以蜂窝状增厚为主,7例以肿块型增厚为主).14例以腹膜增厚表现为主的PMP,彩色多普勒血流成像显示稀疏血流信号7例,另7例未见血流信号.17例进行了手术治疗,术中见大网膜呈板状增厚6例,其中4例术前超声显示网膜普遍增厚;手术中见大网膜呈结节状5例,术前超声所见2例;手术见果冻样腹水11例,而术前超声检查15例呈黏液样腹水;术中发现病变原发于阑尾或回盲部6例,而术前超声诊断仅发现1例.结论 超声检查对PMP有较高诊断准确率,应作为首选影像诊断手段;PMP的超声表现为黏液样腹水和大网膜普遍或结节状增厚,具有较高特异性,而对原发病灶显示率较差.     

高频超声诊断小儿腹股沟疝大网膜嵌顿伴化脓的价值

目的探讨高频超声对小儿腹股沟疝大网膜嵌顿伴化脓的诊断价值。方法回顾性分析经临床手术及病理证实的13例小儿腹股沟疝大网膜嵌顿伴化脓的声像图表现，并对其伴随的睾丸及其他并发症进行总结分析。结果误诊1例，其余12例的声像图特点为疝囊内不均质中强回声区内见多个不规则、大小不等的无回声区，可呈网格状，通过疝囊颈与腹腔相通。中强回声及无回声区内均未见血流信号。13例中12例伴有1种或多种并发症。结论小儿腹股沟疝大网膜嵌顿伴化脓具有特征性的声像图表现，高频超声可作出正确诊断，同时可检出睾丸情况及其他并发症。     

彩色多普勒超声诊断腹膜假性粘液瘤临床应用

目的探讨彩色多普勒超声在腹膜假性粘液瘤诊断中的价值。材料与方法回顾性分析5例经手术、病理证实的腹膜假性粘液瘤患者声像图特点。结果腹膜假性粘液瘤的图像表现:本组病例均可显示腹、盆腔积液暗区,4例内显示为密集点状回声暗区,2例经超声显示大网膜增厚,彩色多普勒显示2例在增厚网膜上显示少许血流信号,另3例未能显示血流信号。结论腹膜假性粘液瘤的彩色多普勒声像图表现有一定特征性,彩色多普勒超声诊断腹腔假性粘液瘤安全、便捷,可作为腹膜假性粘液瘤的首选检查方法。     

Acute torsion and necrosis of the greater omentum herniated into a foramen of Morgagni

Computed tomography is mandatory in the investigation of the acute abdomen and can provide the physician with crucial information to decide whether the patient should be treated surgically or conservatively. An unusual cause of acute abdomen is presented. Computed tomography suggested the diagnosis of omental torsion and necrosis. At surgery, the greater omentum and part of the transverse colon were incarcerated in a small diaphragmatic hernia of the Morgagni type. Received: 18 April 2000/Revision accepted: 31 May 2000     

Omental torsion: CT features

A 33-year-old male presented to the emergency department complaining of right upper quadrant pain and was initially diagnosed with acute cholecystitis. Abdominal computed tomography showed a whirling pattern of fatty streaks and vessels within the greater omentum, and surgery confirmed infarction of the omentum secondary to torsion. We report a case of surgically and pathologically proven omental torsion that demonstrated the typical whirling appearance on computed tomography.     

超声检查对原发性肝癌腹腔转移的初步研究

目的探讨超声在原发性肝癌腹腔转移诊断中的临床应用价值。方法回顾性分析28例原发性肝癌腹腔转移患者的超声表现、手术所见及甲胎蛋白(AFP)、糖类抗原19-9等临床资料。结果超声诊断腹腔转移21例,漏诊7例。16例腹腔转移患者表现为腹腔内孤立或散在多发结节,余5例表现为腹腔内巨大实性结节。单发结节11例,多发结节10例,CDFI探及17例患者结节内有血流信号。结论结合肝癌原发病灶的情况和AFP、糖类抗原19-9血清学资料,对于高度可疑发生腹腔转移的患者在超声检查时应注意全面扫查,重点扫查中上腹网膜区;对于腹腔内肠气干扰明显的患者可结合CT等其他影像学检查。     

Omental Infarction: Case Series and Review of the Literature

Background: Omental infarction is a rare disease entity that can cause acute or subacute abdominal pain. In the past, it was thought that omental infarction mainly occurred on the right side because it was detected when surgery was performed on patients who complained of abdominal pain on the right side. Objective: We present this case to demonstrate that omental infarction can occur at any site, including the epigastric area and the lower abdomen, and even on the left side where the greater omentum is located. Case Report: Four patients with omental infarction presented to the Emergency Department with various clinical symptoms. All of them were diagnosed by computed tomography scan. Omental infarction occurred on the right side in 2 patients, at the epigastric area in 1 patient, and on the left side in 1 patient. Three were improved with supportive care. Laparoscopy was performed in 1 patient because his abdominal pain persisted despite conservative treatment. Conclusion: Omental infarction should be included in the differential diagnosis list of acute abdominal pain because it can occur at any site. In addition, because this disease runs a self-limited course, conservative care is recommended. Thus, unnecessary operations can be avoided in cases where omental infarction is diagnosed by imaging studies.     

Torsion of a giant omental cyst mimicking ascites

We report a case of omental cyst in an 11-month-old infant. The cyst occupied nearly the whole abdomen and mimicked massive ascites on sonography. The correct preoperative diagnosis was achieved through the use of CT, and partial torsion of a huge omental cyst was found at surgery. The diagnostic role of sonography and CT in ascites of unknown etiology is emphasized.     

梗阻性子宫颈发育异常的超声特征及其诊断价值

目的探讨梗阻性子宫颈发育异常的超声特征及诊断价值。 方法回顾2014年1月至2021年12月于四川大学华西第二医院诊治,并经手术和病理证实为梗阻性子宫颈发育异常的患者12例,总结其超声图像特点,分析超声诊断价值及相关合并症的诊断。 结果梗阻性子宫颈发育异常：以术后诊断为标准,本组病例中,超声正确诊断梗阻性子宫颈发育异常8例,误诊4例,诊断率为66.7%（8/12）,误诊病例包括1例子宫颈未发育、2例子宫颈外口闭塞和1例子宫颈残迹。阴道闭锁：根据术中所见,共有11例患者合并阴道闭锁,其中阴道完全闭锁9例,阴道上段闭锁2例。术前超声正确诊断阴道闭锁8例,漏诊3例,诊断率为72.7%（8/11）。其他：以术后诊断为标准,超声正确诊断单侧或双侧输卵管积血5例,漏诊3例,误诊1例;超声诊断卵巢子宫内膜异位囊肿5例,误诊1例。 结论超声可显示宫颈形态、合并的子宫畸形、是否存在阴道闭锁及附件情况,是梗阻性子宫颈发育异常的首选检查方法。     

超声在小儿睾丸下降不全并发扭转中的诊断价值及其临床意义分析

目的 分析探讨超声在小儿睾丸下降不全并发扭转中的诊断价值及其临床意义。方法 选取我院于2011年4月至2015年11月期间收治的312例睾丸下降不全患儿的病例资料进行回顾性分析,其中有9例患儿经手术治疗后证实有睾丸扭转的手术病理结果存在及其超声像图表现。结果 312例睾丸下降不全患儿病例中筛选出9例（2.9%）合并有睾丸扭转的患儿,其年龄、临床表现、手术结果等各项基本资料见表1。超声未显示正常睾丸声像患儿有1例,只有左侧腹股沟粗大网络样回声出现;声像图显示睾丸实质回声正常的患儿有1例,睾丸血流丰富,与精索连接处有“漩涡状”血流信号出现;超声像图有实质不均匀低回声团出现的患儿有6例,彩色多普勒显示睾丸内无血流信号,睾丸包膜不光滑;出现有睾丸畸胎瘤的患儿有1例。结论 临床上睾丸下降不全的患儿不少,但是同时合并有睾丸扭转的则不多,超声检查对于早期发现这类患儿有着较好的诊断价值和极为重要的临床意义。     

Laparoscopic treatment of primary omental torsion: Case report and literature review

Omental torsion is a rare cause of acute abdominal pain. The diagnosis is rarely made preoperatively. The treatment has been classically open. We present a case of omental torsion laparoscopically. A 63‐year‐old man was admitted to the emergency department. The patient had a right upper quadrant pain that started 3 d before his admission. The omentum was freed in a blunt fashion by identifying a point of torsion in the base of the mass. Partial omentectomy was performed with the assistance of a harmonic scalpel. The specimen was retrieved in a bag through a 3 cm left flank incision extended from a 10 mm port site. The pathology evaluation revealed an infarcted omentum. The patient had instant relief of pain, and the recovery was uneventful, with the patient beings discharged 2 d postoperative. The laparoscopic treatment of omental torsion is a safe, feasible and effective alternative.     

彩色多普勒超声诊断和鉴别诊断小儿睾丸扭转

目的 评估彩色多普勒超声诊断及鉴别诊断小儿睾丸扭转的价值。 方法 回顾分析因急性阴囊肿痛而接受彩色多普勒超声检查的125例患儿的声像图特征,并与手术病理、临床最终诊断相比较。 结果 125例中,急性睾丸扭转14例,超声诊断符合率92.86%(13/14),均接受手术治疗,其中11例睾丸完全坏死切除,CDFI显示睾丸内无明显血流信号,3例手术复位后睾丸存活,CDFI示睾丸内有少量血流信号;急性睾丸附件扭转68例,睾丸上极或与附睾间见回声不均质结节,内无血流信号,超声诊断符合率97.06%(66/68);急性附睾炎43例,附睾内血流信号明显增多,超声诊断符合率100%(43/43)。 结论 彩色多普勒超声对小儿睾丸扭转具有较高的诊断及鉴别诊断价值,是临床首选的影像检查方法。