缺血性结肠炎的超声图像表现

Sonographic manifestation of ischemic colitis

目的探讨缺血性结肠炎的超声图像特点以及超声诊断价值。方法使用3．5～5．0MHz腹部探头和7．0～14．0MHz高频超声对12例因急性腹痛、便血患者行二维基波、自然组织谐波和彩色多普勒超声检查，分析结肠肠壁增厚的部位、范围、壁厚和彩色多普勒血流等声像图特征。结果全部病例经结肠镜或临床治疗监测、随访证实，超声定位符合率100％（12／12），其中病变累及右半结肠1例（8．4％），左半结肠7例（58．4％），横结肠2例（16．6％），脾曲2例（16．6％）。增厚结肠壁的长度范围10．0～20．0cm（平均15．0cm），壁厚0．5～2．0cm（平均1．3cm），病变呈均匀、全周性增厚。CDFI：全部病例肠系膜上动静脉内未见血栓，4例（33．3％）增厚结肠壁间有少量彩色血流信号，8例（66．7％）未见彩色血流信号。结论超声对病变的分布、范围、肠壁厚度、彩色血流等做出正确的判断，超声对缺血性结肠炎的诊断和随访、监测对临床有重要帮助。

Objective To investigate the characteristics and value of ultrasound in the diagnosis of ischemic colitis. Methods Fundamental imaging, native tissue harmonic imaging and color Doppler imaging were performed in 12 patients with acute abdominal pain and rectal bleeding. The probe frequencies were 3.5-5.0 MHz and 7.0-12.0 MHz. We analyzed the location, approximate length, colon wall thickness and color Doppler flow imaging of the involved colonic segment. Results All the diagnosis were confirmed by colonoscopy or treament montoring and follow-up. The location of the ischemic colitis could be shown correctly in 12 of 12 patients （100%）. Ischemic colitis was identified on the right side in one patient （8.4%）, in the left side in seven patients （58.4%）, in the transverse colon in two patients （16.6%）, in the splenic flexure in two patients （16.6%）. The length of involvement varied from 10.0-20.0 cm （mean length, 15.0 cm）. The symmetric thickness of the colon wall ranged from 0.5 to 2.0 cm （mean, 1.3 cm）. Little color Doppler flow was observed in the wall of the affected colon segment in four patients （33.3%）. Flow was absent in the eight patients （66. 7%）. There was no thrombus demonstrated in the superior mesenteric vein or superior mesenteric artery. Conclusion Ultrasound could correctly estimate location, approximate length, wall thickness and color Doppler flow imaging of the involved colon. Ultrasound plays an important role in diagnosis, follow-up and monitor of ischemic colon disease.