小儿美克尔憩室及其并发症的超声诊断

Sonographic diagnosis value of Meckel diverticulum and its complications in children

目的探讨小儿美克尔憩室及其合并症的超声表现特征及其诊断价值。方法回顾32例手术病理证实为美克尔憩室的患儿,术前行超声检查并分析超声表现及其特征。结果超声表现为管状结构或椭圆形囊性肿块7例,壁呈双层结构,内壁高回声,外壁低回声,内壁不规则,具有回肠壁的特征,壁上可测及血流信号,此为小儿美克尔憩室的特征性表现;表现为混合性肿块5例;以短期内反复发作肠套叠为主要表现6例;表现以肠梗阻为主6例,肠管积气3例;超声未见异常5例。结论超声在术前可诊断部分美克尔憩室,但病变如果以肠套叠或肠梗阻为主要表现时其声像图表现会掩盖憩室病变,憩室较小或肠气较多时超声易漏诊。

Objective To investigate the sonographic characteristic and diagnostic value of Meckel diverticulum and its complications in children.Methods Thirty-two cases with Meckel diverticulum were confirmed by operation and pathology.The sonographic appearances were analyzed.Results In seven patients,the Meckel diverticulum appeared as a fixed cystlike or tubular mass that had a thick,double layers wall with an external hypoechoic rim and an internal hyperechoic line,an appearance that has also been the gut signature and color flow on its wall;in five patients,the Meckel diverticulum demonstrated complex mass;intussusception recurrented in six patiemts,ileus in six patents,flatus in three patients,and normal in five patients.Conclusions Ultrasonography may diagnosis a part of Meckel diverticulum in children preoperation.Meckel diverticulum with intussusception or ileus,the small Meckel diverticulum or more flatus around could be misdiagnosed.