右下腹肠壁增厚型肠道病变的超声影像表现及其鉴别诊断

The Imaging Features of Thickened Bowel Wall at the Lower Quadrant of Abdomen by Ultrasound and Its differential Diagnostic Value

目的探讨超声检查对右下腹肠壁增厚型肠道病变的诊断和鉴别诊断的临床价值。方法回顾性分析2009年1月-2013年4月眉山市中医医院、眉山中铁医院和四川大学华西医院收治的经内镜活体组织检查或手术病理检查证实的右下腹肠壁增厚型肠道病变共416例的超声影像特点及临床资料(其中包括阑尾炎及阑尾周围脓肿、回盲部肿瘤、梅克尔憩室、肠重复畸形,克隆病、肠结核),并对误诊情况进行了分析。结果 416例病变中,炎症性疾病304例,肿瘤性疾病90例,先天性疾病22例;在超声声像图的表现为囊性团块19例,囊实性混合性团块77例,实性团块320例;416例患者中,肠壁呈弥漫型改变56例,多节段型改变54例,局限型改变306例。结论超声检查对右下腹肠壁增厚型肠道疾病的诊断和鉴别诊断有较好的临床价值。

Objective To evaluate the value of ultrasound in the differential diagnosis of thickened bowel wall at the lower quadrant of abdomen. Methods The ultrasonic and clinical data of 416 cases of bowel wall thickening at the lower quadrant of abdomen were retrospectively analyzed between January 2009 and April 2013 in Meishan Traditional Chinese Medicine Hospital, Meishan Chinese Railway Hospital and West China Hospital of Sichuan University. The diseases included appendicitis, periappendiceal abscess, Meckel＇s diverticulum, intestinal duplication, Crohn＇s disease and intestinal tuberculosis. Misdiagnoses were also analyzed. Results Among the 416 patients, there were 304 cases of inflammation, 90 of tumors, and 22 of congenital diseases. On ultrasound images, they manifested as cystic mass in 19 cases, mixed solid and cystic mass in 77 cases, and solid mass in 320 cases. Of all the cases, there were 56 cases of diffused changes, 54 of multiple-segment changes, and 306 of focal changes. Conclusion Ultrasound is a valuable diagnostic imaging tool in the differential diagnosis of bowel thickening diseases at the lower quadrant of abdomen.