小儿消化道重复畸形超声诊断价值

Ultrasound in children with the diagnosis of the alimentary duplicationin

目的探讨小儿消化道重复畸形的超声诊断价值。方法回顾性分析我院2000年4月至2010年9月收治的25例消化道重复畸形患儿的超声声像图表现。结果 25例消化道重复畸形患儿发生在回肠20例,空肠3例,结肠1例,食管1例。其中20例呈典型的声像图表现:大小不等厚壁囊性团块,外径2～11cm,<5cm者16例。囊壁的边界尚清,肠壁呈"强-弱-强"3层结构特点,彩色多普勒可显示囊壁血流信号;1例超声声像图显示为右侧胸腔内肠管样回声,肠管扩张,可见蠕动,彩色多普勒示肠管可见点状血流信号;4例呈非典型声像图表现,其中2例表现为薄壁囊性团块,未显示明显肠壁3层结构,内可见分隔样回声,彩色多普勒示囊壁无明显血流信号;1例仅表现为肠梗阻,部分肠管积液、扩张;1例仅有少量腹腔积液,未显示明显腹腔团块回声。结论小儿消化道重复畸形的超声声像图表现具有一定特征性。提高对其病理类型的认识并采用合适的超声检查操作方法,将有助于提高该病的术前诊断水平。

Objective To investigate the value of ultrasound diagnosis in alimentary duplication in children.Methods The sonographic features were analysed retrospectively in 25 cases of alimentary duplication in Shenzhen Children's Hospital from April 2000 to September 2010,compared with surgical and pathological results.Results A total of 25 cases occurred in the ileum 20 cases,3 cases in jejunum,one case in colon,one case in esophagus.The sonography of 20 patients with alimentary duplication showed typical sonographic appearances including a thick-walled cystic mass and sizes of 2-11 cm(16 cases<5 cm),three-tier structure of intestinal wall.The color Doppler flow image(CDFI)showed that thick-walled had some blood supply.One patient with esophagus duplication showed the bowel-like echo accompanied with peristalsis in the right chest.Four patients showed atypical sonographic appearances including 2 cases of the thin-walled cystic mass with the separate echo,one case of intestinal canal extension and one case of peritoneal fluid.Conclusions There are characteristic ultrasound features in children with alimentary duplication.Improving the knowledge of pathological types and mastering the operation method can help improve the level of preoperative diagnosis.