高频超声对小儿Meckel憩室及其并发症的诊断价值

目的探讨小儿Meckel憩室及其并发症的高频超声声像图特点及其诊断价值。方法回顾21例经手术病理证实为Meckel憩室的小儿,分析其在术前行高频超声检查时的超声表现及特征。结果超声表现为管状回声肿块5例,囊样回声肿块6例,混合型回声肿块4例。表现为肠套叠2例,表现为肠梗阻2例,此为Meckel憩室并发症的表现。另外因气体干扰未能显示异常1例;超声未见异常1例。高频超声检查与临床诊断结果比较差异有统计学意义（P〈0.05）。结论高频超声是有效的Meckel憩室诊断方法,部分小儿Meckel憩室术前超声可诊断。若患者表现为阑尾炎、肠套叠及肠梗阻时会因并发症声像图而掩盖原发Meckel憩室病变,造成漏诊。另外当憩室较小、位置靠后及大量肠气干扰时也容易漏诊。

The Value of High-resolution Ultrasonography in the Diagnosis of Pediatric Meckel Diverticulum and Its Complications

Objective To investigate the high-resolution ultrasonographic characteristics and diagnostic value of pediatric Meckel＇s diverticulum and its complications. Methods 21 children with Meckel＇s diverticulum were confirmed by operation and pathology. And the preoperative high-resolution ultrasonographic appearances of them were analyzed. Results The ultrasonic manifestations of Meckel＇s diverticulum appeared as tubular echo mass in 5 patients, cysflike echo mass in 6 patients, complex echo mass in 4 patients. And the Meckel＇s diverticulum appeared as intussusception in 2 patients, intestinal obstruction in 2 patients, these were the complications of Meckel＇s diverticulum. In addition, l case was not showed abnormal due to the flatus interference; and 1 case was showed normal by the uhrasonography. The difference between the result of examination of high-resolution ultrasonography and clinical diagnosis was statistically significant （P〈0.05）. Conclusion High-resolution uhrasonography is an effective method for the diagnosis of Meckel＇s diverticulm, and by which some children with Meckel＇s diverticulm can be diagnosed before operation. Patients with appendicitis or intussusception or intestinal obstruction, might be diagnosed missedly due to the sonogram of the complications concealing the primary lesions of Meckel＇s diverticulum. Furthermore, the patients are easily diagnosed missedly when the MeckeFs diverticulm is small, and locates at the back or more flatus around.