膈疝的影像学诊断

Imaging Diagnosis of Diaphragmatic Hernia

目的提高对膈疝的影像学特征认识。方法对28例经手术证实的膈疝的X线平片,钡餐检查或CT扫描征象进行了回顾性分析。结果膈疝的征象主要有:1)膈面异常:膈面轮廓部分或全部不清;膈上半圆形块状阴影或跨膈肌阴影。2)胸腔积气、积液或块状影:中下肺野囊状或蜂窝状透光阴影;胸腔大气液平面;心膈角区块状影。胸腔内阴影形态可变。3)钡餐(或泛影葡胺)检查胸腔内见胃肠道的影像特征。4)CT扫描胸腔内见胃肠道、网膜及肠系膜、肝脾肾。结论正确运用这些影像学检查和认识影像学表现对提高膈疝的术前诊断有重要价值。

Objective To analyze the imaging features of diaphragmatic hernia and evaluate various diagnostic methods. Methods The imaging features of diaphragmatic hernia were reviewed in 28 surgery confirmed cases. Results The signs of diaphragmatic hernia were 1 ） the unusual diaphragm： including diaphragm outline with partial or complete unclear ness, semi-circular cubic shadow on the diaphragm and agglomeration shadow; 2） the thoracic accumulating gas and fluid shadow or agglomeration shadow： including mid - low half wild lung theca or alveolate transparent shadow and heart diaphragm angle block form shadow, and the thoracic shadow was variable; 3） stomach and intestine features were observed by barium meal images（or injecting into intensive shadow grape amine through stomach tube） ; 4） OT thoracic scan showed stomach and/or intestine, omentum and mesentery, liver, spleen and kidney form in the thoracic cavity. Conclusion It is very important that using above - mentioned methods and mastering these signs to diagnose diaphragmatic hernia before surgery.