Lemmel综合征超声诊断价值探讨

The application of ultrasound in the diagnosis of Lemmel syndrome

目的探讨超声在Lemmel综合征诊断中的价值。方法对36例经超声、计算机断层扫描(CT)和内镜下逆行性胰胆管造影(ERCP)检查和手术病理检查证实为Lemmel综合征患者的超声、CT及ERCP影像资料进行回顾性分析。结果 36例Lemmel综合征患者超声显示十二指肠乳头旁憩室36个,表现为3种回声类型:高回声型24个,囊实混合性回声8个,强弱不均性回声型4个。憩室位于十二指肠环内侧呈囊状突出于十二指肠小弯侧壁,内为气体强回声、含液为主囊实回声及含残留食物的不均质回声,憩室最大径线6~32 mm;36例患者胆管系统均伴有不同程度的扩张,胰管轻度扩张12例。结论 Lemmel综合征十二指肠乳头旁憩室图像特征在Lemmel综合征超声诊断中有较高的临床应用价值。

Objective The aim of this study was to explore the value of ultrasound in the diagnosis of Lemmel syndrome. Methods Ultrasound images of 36 patients with Lemmel syndrome confirmed by ERCP or surgery were retrospectively analyzed, and the image′s feature of ultrasound was explored. Results The ultrasound feature of Lemmel syndrome was showed as cystic protuberance from lesser curvature of duodenum, and three types of ultrasound characteristics were found： hyperechogenicity of gas, solid-cystic echogenicity full filled with fluid and inhomogeneous echogenicity full filled with food residue. The presence of hyperechogenicity（24 cases）, solid-cystic echogenicity（8 cases）, inhomogeneous echogenicity（4 cases） were found in 36 patients with periampullary diverticulum, and the biggest diameter of periampullary diverticulum was 6 to 32 mm. All of the patients（36 cases） were with mechanical obstruction in the common bile duct, and 12 patients were found mild dilatation of the pancreatic duct. Conclusion Higher clinical application value of ultrasound has been found when ultrasound is used in the diagnosis of Lemmel syndrome.