体位对超声造影诊断食管裂孔疝的影响

Effect of posture on esophageal hiatal hernias diagnosis in contrast-enhanced ultrasonography

目的总结食管裂孔疝(EHH)患者不同体位的超声造影表现,研究超声造影诊断EHH时,体位对其的影响。方法对56例EHH患者平卧位、左侧卧位、右侧卧位3种体位时疝囊显示率、疝囊及膈肌食管裂孔最大直径及平均直径进行比较,观察三种体位的超声造影差异。结果 56例EHH患者3种体位超声造影差异明显,疝囊显示率左侧卧位为64.29%,平卧位为89.29%,右侧卧位为100.00%,较小的5例滑动性EHH平卧位及左侧卧位时均不显示疝囊,仅右侧卧位时才能清晰显示;疝囊最大直径左侧卧位为4.23 cm,平卧位为5.05 cm,右侧卧位为5.32 cm;食管裂孔最大直径左侧卧位为2.93 cm,平卧位为3.73 cm,右侧卧位为3.98 cm;食管裂孔平均直径左侧卧位为(2.04±0.89)cm,平卧位为(2.89±0.84)cm,右侧卧位为(3.35±0.63)cm;疝囊平均直径左侧卧位为(3.36±0.88)cm,平卧位(4.24±0.81)cm,右侧卧位(4.71±0.61)cm。结论 EHH患者受检体位对超声造影诊断本病时有一定影响,合适的检测体位可提高EHH的检出率。

Objective To summarize the feature of contrast enhanceduhrasound for the EHH patients with different positionsm, study the effect of posture on esophageal hiatal hernias diagnosis in contrast-enhanced ultrasonography. Methods The hernial sac display rate, maximum diameter and average diameter of hernial sac and diaphragmatic muscle hiatus in horizontal position, right lateral position, left lateral position among 56 patients suffered with EHH were compared, then the ultrasound contrast differences in the three postures were observed. Results 56 cases of pa- tients with EHH had significant differences in ultrasound contrast, the display rate of hernial sac in the left lateral po- sition was 64.29%, horizontal position was 89.29%, right lateral position was 100.00%. The hernia sac were not dis- played in 5 cases with slither EHH in horizontal position and left lateral position, only be clearly displayed in the right lateral position. Hernia sac maximum diameter in the left lateral position was 4.23 cm, horizontal position was 5.05 cm, right lateral position was 5.32 cm. The maximum diameter of esophageal hiatus in left lateral position was 2.93 cm, horizontal position was 3.73 cm, right ）ateral position was 3.98 cm. The average diameter of esophageal hiatus in the left lateral position was （2.04 ± 0.89） cm, horizontal position was （2.89 ± 0.84） cm, right lateral position was （3.35 ± 0.63） cm. The average diameter of hernia sac in left lateral position was （3.36 ± 0.88） cm, horizontal position was （4.24± 0.81） cm, right lateral position was （4.71 ± 0.61） cm. Conclusion The examination position of EHH patients has certain influence on contrast-enhanced ultrasound for diagnosis of EHH. A suitable position can improve the de- tection rate of this disease.