低频与高频超声加肠系声学造影诊断结核性腹膜炎

The Value of High and Iow Frequehcy Ultrasound and Mensentary Acoustic Contrast Examination in Diagnosis of Tubercular Peritonitis

目的 :提高结核性腹膜炎的超声诊断水平。材料和方法 :用低频 (3 5MHz)和高频 (7 0或 7 5～ 10MHz)超声检查本病 2 9例 ,同时进行肠系声学造影 2 3例。病例均经证实。结果 :超声诊断正确率为 89 7% ,误诊 3例。超声表现为腹水(82 8% ) ,壁层腹膜弥漫性增厚 (89 7% ) ,脏层腹膜、网膜增厚并肠袢固定 (82 8% ) ,干酪坏死物及脓肿 (41 4% ) ,淋巴结肿大 (5 5 2 % ) ,其中以壁层腹膜所见具有特征性。肠系声学造影显示肠曲团聚粘连 18例、肠道结核 2例。结论

Purpose: To improve the ultrasonic diagnostic confidence of tubercular peritonitis. Materials and Method: 29 cases were examined by low frequency (3.5 MHz) and high frequency (7.0—10 MHz) ultrasonegrahy and in the meanwhile 23 cases underwent mensentery acoustic contrast study. All cases were proved. Result: Ultrasonic diagnositc accuracy was 89.7%. 3 cases were misdiagnosed. Ultrasonic manifestations included ascites (82.8%), peritoneum thickening (89.7%), visceral peritoneum and mentum thickening together with intestinal adhesion (82.8%), caseous necrosis and abscess (41.4%), lymphadenectasis (55.2%). Mesentery acoustic contrast examination showed 18 cases of intestinal adhesion and 2 intestinal tuberculosis. Conclusion: Low frequency Ultrasound with high frequency technique and mensentery acousitc contrast examination are useful in diagnosing tubercular peritonitis.