超声双重造影诊断肠系膜上动脉综合征

Double contrast-enhanced ultrasound in diagnosis of superior mesenteric artery syndrome

目的探讨超声双重造影(DCUS)诊断肠系膜上动脉综合征(SMAS)的应用价值。方法收集经上消化道钡餐造影证实为SMAS的23例患者(SMAS组),随机选取上消化道造影检查结果正常的25名健康成人作为对照组,行常规超声及DCUS检查,测量肠系膜上动脉与腹主动脉(SMA-AO)夹角,夹角处及夹角前十二指肠内径(D夹及D前),计算D前/D夹,并进行统计学比较。结果 DCUS能清楚显示SMA-AO。与对照组相比,SMAS组SMA-AO夹角及D夹减小,D前及D前/D夹增大,差异均有统计学意义(P均<0.05)。分别以SMA-AO夹角<15°、D夹<10mm、D前>30mm及D前/D夹>2.7为标准,超声诊断SMAS的正确率分别为73.91%(17/23)、91.30%(21/23)、82.61%(19/23)和100%(23/23)。结论 DCUS能够清晰显示SMA-AO的解剖关系,对临床诊断SMAS有一定指导意义。

Objective To explore the clinical value of double contrast-enhanced ultrasound （DCUS） in diagnosis of superi- or mesenteric artery syndrome （SMAS）. Methods Twenty-three patients with SMAS confirmed with upper gestrointesti- nal barium examination were collected as SMAS group. Then 25 healthy adults confirmed with upper gestrointestinal bari- um examination were randomly chosen as control group. Conventional ultrasound and DCUS were used for both groups to measure SMA-AO angle, duodenum diameter between SMA and AO （D1）, duodenum diameter before SMA and AO （D2）, and the ratio of D2 to D1 （D2/D1 ） was calculated. Results SMA-AO angle could be showed clearly in all subjects by DCUS. Compared with control group, SMA-AO angle and D1 in SMAS group were statistically lower （both P〈0. 05）, whereas D2 and D2/D1 in SMAS group were statistically higher （both P〈0.05）. Taking SMA-AO angled 15°, D1 〈10 ram, D2〉30 mm and D2/D1 〉 2. 7 as diagnosis standards, and the accuracy of ultrasound in diagnosis of SMAS was 73.91% （17/23）, 91.30% （21/23）, 82.61% （19/23） and 100% （23/23）, respectively. Conclusion DCUS can show the anatomy of SMA-AO clearly, therefore is helpful to clinical diagnosis of SMAS.