彩色多普勒超声诊断会阴疝的价值

Value of color Doppler ultrasonography in diagnosis of perineal hernia

目的探讨彩色多普勒超声诊断会阴疝的临床价值。方法利用彩色多普勒超声对15例会阴疝患者行术前检查,观察其超声表现。结果前会阴疝14例,疝囊位于尿道与阴道之间;后会阴疝1例,疝囊位于阴道与直肠远端及肛管之间。会阴疝表现为疝囊近端与腹腔相通,远端为盲端。疝内容物为肠管时呈肠壁回声、肠腔内容物或气体回声,CDFI示肠壁少量血流信号;内容物为网膜时呈不均匀中高回声,CDFI示点状血流信号;内容物为膀胱时呈囊状无回声,CDFI示囊壁少量血流信号。其中1例合并会阴部血管瘤,1例合并会阴部纤维脂肪瘤。结论彩色多普勒超声检查可判断有无会阴疝,明确疝的类型,对诊断、鉴别诊断会阴疝具有重要价值。

Objective To investigate the clinical value of color Doppler ultrasonography in diagnosis of perineal hernia. Methods Fifteen patients with perineal hernia were examined with color Doppler ultrasonography before operation. The ultrasound findings were analyzed. Results There were 14 patients with anterior perineal henia with hernia sacs located be- tween urethra and vagina, and 1 patient with posterior perineal henia with hernia sac located between vagina and rectum. The upper part of the hernia sac extended to abdominal cavity, and the distal part was caecum. When the herniated tissue was intestine, bowel wall, enteric contents, or gasecho could be observed, while CDFI showed little blood flow signals. When the herniated tissue was epiploon, clutter hyperecho with spot blood flow could be found. If the bladder herniated, cystic anecho with little blood flow of the bladder wall could be detected. There were 1 perineal hernia patient accompanying with perineal hemangioma and 1 accompanying with perineal fibrolipoma. Conclusion Color Doppler ultrasonography is useful not only to diagnosing but also to identifying the type of the perineal hernia.