小儿肠重复畸形的超声诊断

目的: 探讨小儿肠重复畸形的超声图像特征及与肠系膜囊肿的鉴别.材料和方法: 回顾性分析经手术、病理证实的13例肠重复畸形和17例肠系膜囊肿的超声图像表现.结果: 检出肠重复畸形9例,漏、误诊4例.与肠系膜囊肿对比,肠重复畸形声像图主要表现囊性肿块较小(直径<10cm),壁厚、分三层、多无分隔.结论: 观察肿块的大小、囊壁结构及囊内分隔,有助于鉴别肠重复畸形与肠系膜囊肿.     

小儿腹痛84例的超声诊断分析

目的探讨超声对小儿腹痛的诊断价值。方法回顾性分析84例以腹痛为主要症状的患儿超声声像图特点，比较不同疾病患儿超声表现的差异性。结果84例患儿中，超声诊断为肠系膜淋巴结炎34例，急性阑尾炎13例，诊断准确率100％；肠痉挛21例；肠系膜淋巴结结核4例，1例伴有结核性腹膜炎：肠套叠2例；淋巴瘤1例；9例B超下未发现阳性声像图表现，随访最后诊断为慢性胃炎6例，肠道蛔虫病2例，慢性阑尾炎1例。结论超声检查诊断小儿腹痛准确性较高，可以大大减少临床上诊断及治疗的盲目性，值得推广应用。     

高频彩超诊断小儿急性肠系膜淋巴结炎的临床研究

目的:探讨高频彩超对诊断小儿急性肠系膜淋巴结炎的临床价值。方法:对临床可疑小儿急性肠系膜淋巴结炎的患儿,应用高频彩超行腹部扫查,观察肠系膜淋巴结,追踪对比治疗前后声像图变化。并分析其与正常对照组淋巴结的不同点。结果:218例小儿急性肠系膜淋巴结炎,其淋巴结有明显的超声图像改变:淋巴结肿大,纵横比>2,淋巴结内显示较丰富的血流信号,RI 0.52～0.62,治疗前后淋巴结大小、血供差异有统计学意义(P<0.05)。结论:小儿急性肠系膜淋巴结炎有典型的超声表现,高频彩超对小儿急性肠系膜淋巴结炎的诊断有重要的临床意义。     

高频彩色多普勒超声对体表肿块的诊断价值

目的探讨高频彩色多普勒超声在体表肿块中的诊断价值。方法对67例体表肿块患者的超声表现进行回顾性分析,总结其声像图特征,根据其声像图形态、大小、内部回声、边缘回声、血流特点及是否有完整包膜,观察高频彩色多普勒超声对这些患者体表肿块的定性诊断。结果67例中脂肪瘤20例,胴窝囊肿15例,纤维瘤7例,腱鞘囊肿7例,坐骨结节囊肿6例,血管瘤5例,神经鞘膜瘤3例,皮脂腺囊肿3例,脂肪坏死1例。每种疾病声像图特征各异。结论在常见体表肿块的诊断及鉴别诊断中,高频彩色多普勒超声具有重要的临床应用价值。     

腹部钝性损伤中肠系膜破裂的超声检查

目的 :探讨超声对肠系膜破裂的诊断价值。材料和方法 :回顾性分析我院 1997 0 7～ 2 0 0 1 0 5因腹部钝性损伤所致的肠系膜破裂 2 4例的声像图结果与临床表现。所有病例均经手术证实。结果 :2 4例中超声检查均可见腹腔积液 ,其中 8例超声提示有肠系膜破裂可能。结论 :超声有助于临床诊断肠系膜破裂出血。     

经阴道超声诊断卵巢冠囊肿的临床意义

目的 :探讨经阴道超声诊断卵巢冠囊肿的临床意义。方法 :回顾性分析我院67例经术后病理证实为卵巢冠囊肿的超声声像图特征和临床资料,并与病理结果对照。结果:67例中囊肿发生于左侧26例,右侧33例,双侧8例;单纯囊肿型57例,囊内见粟粒样结节、分隔或细点状回声10例。术前超声正确诊断40例,误诊8例,漏诊19例,与术后病理结果比较,诊断符合率59.7%。结论 :卵巢冠囊肿的超声表现有一定的特征性,经阴道超声检查安全、经济、可重复、可动态实时观察,可成为诊断卵巢冠囊肿的首选影像学检查方法。     

成人原发腹部淋巴管瘤超声表现

目的探讨成人原发腹部淋巴管瘤(APAL)的超声诊断价值。资料与方法回顾性分析12例APAL(海绵状淋巴管瘤1例,囊性淋巴管瘤11例)的声像图表现,并与CT血管造影(CTA)和MRI对照。结果 12例APAL患者中,4例发生于脾脏,3例起源于肠系膜,5例位于腹膜后。脾内和肠系膜淋巴管瘤中5例为圆形或浅分叶状,腹膜后5例占位形态不规则。多发多房者3例,单发多房者4例,单发单房者5例。超声显示,囊壁血流3例,2例显示分隔血流。超声提示淋巴管瘤2例,误诊为转移瘤及脂肪瘤各1例,1例肠系膜病变误诊为腹膜后占位。结论成人腹部原发淋巴管瘤的典型表现为多房分隔,超声具有一定的诊断意义。     

肝包虫病的超声声像图特征及其诊断价值

目的:探讨肝包虫病的超声声像图特征及其诊断价值.材料和方法:回顾性分析经手术及病理证实的80例肝包虫病的声像图特征.结果:肝包虫囊肿的声像图分为4种:单发囊肿型7例,多发囊肿型9例,子囊孙囊型12例,囊肿实变型10例.肝泡球蚴病的声像图分为3种:实性肿块型16例,肿块液化型21例,肿块钙化型5例.除2例单发囊肿型声像图缺乏明显的特征(囊底缺少囊砂),术前未能做出明确诊断外,余78例均做出了明确的诊断,诊断符合率97.5%.结论:超声显像对肝包虫病的位置、数目、大小和类型均可做出精确的判断,可作为包虫病的首选检查方法.     

高频彩超对小儿肠系膜淋巴结炎的诊断价值研究

目的:探讨高频彩超对小儿肠系膜淋巴结炎的诊断价值。方法:对3～13岁80例小儿肠系膜淋巴结炎患者进行腹部彩超检查,观察肠系膜淋巴结。结果:80例肠系膜淋巴结炎患者淋巴结有明显的不同程度的超声图像改变。CD-FI:显示肿大淋巴结内血流信号增多。结论:小儿肠系膜淋巴结炎有典型的超声表现,高频彩超对小儿肠系膜淋巴结炎的诊断有重要的临床意义。     

小儿卵巢肿瘤的超声诊断

目的:探讨小儿卵巢肿瘤的超声声像图特征及其诊断价值.方法:2005年1月至2012年12月经手术病理证实的54例卵巢肿瘤患儿纳入研究,全部术前进行彩色多普勒超声检查,回顾性分析其声像图,并结合临床和病理分析.结果:良性肿瘤及瘤样病变45例,恶性肿瘤9例,具体类型为生殖细胞肿瘤68.5％ (37/54)、上皮性肿瘤3.7％(2/54)、性索间质细胞肿瘤3.7％ (2/54)以及瘤样病变24.1％ (13/54).超声声像图显示囊性17例,混合性29例,实性7例,1例黄体囊肿破裂声像图仅表现为腹腔积液.囊性回声肿块均为良性100％ (17/17);混合性回声肿块以良性为主82.7％ (24/29),恶性17.2％ (5/29);实性回声肿块大部分为恶性57.1％ (4/7).良、恶性病变平均直径分别为5.8cm、13.2cm.超声诊断符合率79.6％ (43/54).结论:小儿卵巢肿瘤有一定的超声表现特征,大部分可初步判断肿瘤良恶性,为临床治疗提供帮助.     

Paediatric intraperitoneal cystic masses: 10-year follow-up

We report 18 cases of intraperitoneal cystic masses in paediatric patients collected during the past 10 years in our institution. The radiological and sonographic findings are described and the histopathological correlation documented. According to the classification based on the histological characteristics of the cyst wall there were: 7 lymphangiomas, 5 duplication and enteric cysts, 2 intraperitoneal pseudocysts, 3 cases of mesenteric hydatidosis and 1 case of peritoneal tuberculosis. The purpose of the study was to establish a correlation between the ultrasound and histological findings in mesenteric and omental cysts and to attempt a unified classification based on aetiological and histopathological criteria. Despite the non-specific radiological signs, the sonographic appearance of mesenteric and omental cysts is useful in preoperative diagnosis because it allows lymphangioma, the most aggressive cyst, to be distinguished from other intraperitoneal cystic masses. Furthermore, enteric duplication cysts have specific ultrasonographic characteristics. Correspondence to: C. Lopez     

Sonographic pitfalls in the diagnosis of enteric duplication cysts

OBJECTIVE: The sonographic double wall sign has been well described in the literature and is often the cornerstone in suggesting the diagnosis of an enteric duplication cyst. We report two cases with this sign that were erroneously diagnosed as enteric cysts and a third case without this sonographic feature that proved to be a duplication cyst. Histologic analysis of the specimens helps explain the cause of the sonographic pitfalls. CONCLUSION: The potential sonographic visualization of the split hypoechoic muscularis propria layer or identification of all five layers will increase the specificity in making the sonographic diagnosis of duplication cyst.     

肠系膜肿块的CT诊断

目的 分析肠系膜肿块的CT表现,探讨CT对其定位,定性及鉴别诊断的价值和限度,资料与方法 对经手术,病理,活检等证实的18例肠系膜肿块的CT表现,结合其手术病理及部分超声所见进行回顾分析。选用窗宽300-400HU,窗位0HU观察病灶及其邻近肠系膜。结果 18例肠系膜肿块中,16例发生在小肠系膜（回肠15例,空肠1例）,升,横结肠各1例,其中恶性淋巴瘤6例（非霍奇金病5例,霍奇金病1例）,淋巴管瘤,炎性假瘤各3例,转移瘤2例,血管外皮细胞肉瘤,平滑肌肉瘤,纤维瘤,单纯囊肿各1例,除2例淋巴瘤和1例转移瘤呈多个肠系膜肿块,部分病例伴有腹膜后肿块,其余病例均呈孤立性肿块（此为唯一的CT表现）。肿块推压肠管,部分被肠系膜肿块,部分病例伴有腹膜后肿块,其余病例均呈孤立性肿块（此为唯一的CT表现）,肿块推压肠管,部分被肠管包绕,邻近肠系膜模糊,“三明治”征多见于恶性淋巴瘤。结论 CT对肠系膜肿块有较大的诊断价值。结合病变的解剖,病理基础以及超声特征等,术前多可做出提示性甚至正确的定位,定性诊断,对少数难以确诊的病例,应行CT导引下穿刺活检确诊。     

不典型肾囊肿的影像诊断与鉴别(附9例分析)

目的　探讨不典型肾囊肿的CT、超声、X线特点及诊断价值。方法　回顾分析 9例经手术病理证实的不典型肾囊肿的CT、超声和X线表现。结果　CT及超声对不典型肾囊肿的诊断准确性高 ,9例不典型肾囊肿中 ,出血性肾囊肿 3例 ,钙化性肾囊肿 2例 ,分隔性肾囊肿 3例 ,钙乳性肾囊肿 1例。CT和超声能较好地显示它们的形态和特征。结论　CT和超声对不典型肾囊肿具有较高的诊断价值 ,但对出血性肾囊肿与囊液混浊的囊性肾癌鉴别困难 ,应行超声引导下穿刺活检     

皮脂腺囊肿的超声特征（附52例分析）

目的：通过分析皮脂腺囊肿的声像图特征,提高对本病的诊断水平。方法：对手术病理证实的52例皮脂腺囊肿的声像图特征进行回顾性分析。结果：52例皮脂腺囊肿声像图均表现为圆形或椭圆形低回声肿物,质软,探头加压可变形,边界清晰光滑,有完整的包膜回声,肿物后方回声有增强,内部回声不均匀,呈密集点状或粗颗粒状,大体病理呈豆腐渣样。彩色多普勒血流（CDFI）显示：肿物周边及内部无明显血流信号。结论：彩色多普勒超声在皮脂腺囊肿的诊断中具有较高的价值。     

乳汁潴留性乳腺囊肿的超声表现

目的:研究乳汁潴留性乳腺囊肿的超声表现,评价超声在其诊断和鉴别诊断中的价值。方法:回顾性分析22例共28个乳汁潴留性乳腺囊肿的超声表现,并与病理特征相对照。结果:22例,病变均为单侧,单发19例,多发3例,处于哺乳期12例,哺乳后10例,根据二维声像图特征分为四种类型:I型,囊内低弱回声型;II型,脂液分层型;III型,囊内混合回声型;IV型,类实型。结论:超声检查对乳汁潴留性乳腺囊肿的诊断及鉴别诊断具有很大价值,超声引导下针吸细胞学检查有助于本病的诊断。     

Sonographic detection of Baker's cysts: comparison with MR imaging

OBJECTIVE: The objective of this study was to assess the ability of sonography to reveal Baker's cysts using MR imaging as a gold standard. MATERIALS AND METHODS: The study group consisted of 36 consecutive knees in 36 patients evaluated with both MR imaging and sonography. Inclusion criteria included axial proton density-weighted or T2-weighted MR images, a sonography report that documented the evaluation of the popliteal region of the knee, and sonographic and MR images that were available for review. The MR images were retrospectively reviewed for the presence of Baker's cyst (fluid signal between the semimembranosus and medial gastrocnemius tendons). Sonography reports were compared with the MR imaging results. The sonographic images were also retrospectively reviewed to determine whether any characteristic findings on sonography were significantly associated with the presence of Baker's cyst on MR imaging. RESULTS: Retrospective review of MR images revealed 21 Baker's cysts, one myxoid liposarcoma, one meniscal cyst, and 13 examinations with normal findings. The sonography reports revealed that the 21 Baker's cysts were correctly diagnosed, whereas the meniscal cyst and myxoid liposarcoma were misdiagnosed as Baker's cysts. Retrospective review of sonographic images showed a 100% sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the diagnosis of Baker's cyst when hypoechoic or anechoic fluid was present between the semimembranosus and medial gastrocnemius tendons. No other sonographic characteristics were significant. CONCLUSION: Identification of fluid between the semimembranosus and medial gastrocnemius tendons in communication with a posterior knee cyst indicates Baker's cyst with 100% accuracy.     

Spectrum of sonographic findings in 125 renal masses other than benign simple cyst

The sonographic findings of 125 renal masses that did not meet the sonographic criteria of benign simple cyst were retrospectively reviewed and correlated with the pathologic diagnosis. Of the 125 masses, 102 were renal cell carcinoma. These carcinomas, two of nine angiomyolipomas, and the 14 other renal masses of various histologic types exhibited a broad spectrum of sonographic findings. Seven of nine angiomyolipomas and the one multiloculated cystic nephroma had a rather characteristic sonographic appearance. With the knowledge of this spectrum of sonographic findings and strict attention to scanning techniques and sonographic criteria, the radiologist should be able to define the characteristics of a variety of renal masses and suggest the correct diagnosis. It should be possible to make the diagnosis of angiomyolipoma confidently if the characteristic sonographic and computed tomographic appearance of these tumors can be demonstrated. In some cases, the correct histologic diagnosis of a renal mass can be made only with biopsy or surgery.     

Sonographic evaluation of ovarian torsion in childhood and adolescence

Emergency sonographic examination of the pelvis was performed in 41 girls (mean age, 13 years old) with clinical suspicion of ovarian torsion. Sonographic features consistent with diffuse swelling of the ovarian parenchyma and follicular enlargement in the cortical zone were detected in eight patients and were considered highly suggestive for torsion of the ovary. Surgery revealed ovarian torsion in seven of these cases and hemorrhagic ovarian cyst in one case. A cystic or complex ovarian mass was detected by sonography in five additional cases, and ovarian torsion was included in the differential diagnosis. Surgery revealed ovarian torsion in four of these cases and hemorrhagic ovarian cyst in one. A 100% sonographic sensitivity for space-occupying disease of the ovary was obtained with a positive predictive value of 88% for the diagnosis of ovarian torsion. The specificity of the method was 93%. Sonography appears to be an excellent method to evaluate patients with suspected torsion of the ovary.