膈疝的影像学特征及检查方法评价

Imaging Features of Diaphragmatic Hernia and Evaluation of Its Diagnostic Examinations

目的：分析膈疝的影像学特征，并对检查方法进行比较。材料与方法：本组１６例包括滑动性食管裂孔疝４例，不可复性食管裂孔疝２例，胸腹膜裂孔疝３例，胸骨旁裂孔疝３例，创伤性膈疝４例。１４例摄胸片，１２例作钡餐，２例作钡灌肠，４例作胸部ＣＴ，４例作Ｂ超。结果：１２例膈疝钡餐清楚显示胃、小肠或结肠疝入胸腔内，２例膈疝钡灌肠清晰显示结肠肝曲疝入胸腔，２例膈疝ＣＴ显示部分胃腔疝入胸腔。结论：当膈疝内容物为消化道空腔脏器时，诊断膈疝运用钡餐和钡灌肠为最佳选择。

Objective: To analyze the imaging features of diaphragmatic hernia and to evaluate various diagnostic methods. Materials and Methods: The imaging feature of diaphragmatic hernia was reviewed in 16 cases, including sliding hiatus hernia ( n =4), irreducible hiatus hernia ( n =2), pleuroperitoneal hiatus hernia ( n =3), parasternal hiatus hernia ( n =3) and traumatic diaphragmatic hernia ( nBZ=4). Chest film was performed in 14, GI in 12, BE in 2, chest CT in 4 and Bsonography in 4. Results: Herniation of stomach and small or large intestinal loop into the thorax was clearly seen on all GI examinations of 12 cases. The hepatic flexure of the colon was found in the thorax in 2 patients received BE. Part of stomach abnormally displaced into the thorax was demonstrated on CT scan in 4 cases. Conclusion: GI and BE are the first choice in diagnosing diaphragmatic hernia when hollow viscus, such as digestive tract, become hernia content.