超声在脐尿管疾病诊断中的应用价值

Application value of ultrasound in diagnosis of urachal disease

目的分析脐尿管疾病的超声表现,探讨超声诊断该病变的临床应用价值。方法对经手术病理或CT证实的19例脐尿管异常患者行二维超声和彩色多普勒超声检查,其中8例患者行超声造影检查,观察肿块的微血管灌注情况。结果 8例脐尿管囊肿中5例二维超声呈典型的无回声表现,3例呈低回声的肿块经超声造影后明确诊断;7例脐尿管癌超声均呈不均匀性低回声表现,3例伴钙化,其中3例行超声造影,结果显示肿块呈不均匀性高增强;1例脐尿管脓肿超声表现不典型,误诊为膀胱癌;1例脐尿管憩室通过特征性的位置和典型的超声表现明确诊断;2例脐尿管黏液性囊腺瘤超声表现为膀胱前壁边界清晰回声均匀的实性低回声结节,超声造影呈乏血供表现。结论脐尿管疾病有特异性的声像图表现,超声造影可以明确病灶的性质和浸润范围,能提高诊断准确率,具有重要临床应用价值。

Objective To analyze the ultrasonic manifestations of urachal disease,and to explore the clinical application value of ultrasound in diagnosis of this disease.Methods Nineteen patients with urachal anomalies were examined by two-dimensional ultrasound and color Doppler ultrasound, all cases were confirmed by pathology or CT,8 patients were underwent contrast-enhanced ultrasound （CEUS）,the microvascular perfusion in the tumors was observed. Results In 8 cases of urachal cyst,5 cases showed typical anechoic sonogram by two-dimensional ultrasound,and 3 cases with hypoechoic masses were diagnosed by CEUS.There were 7 cases of urachal carcinoma with inhomogeneous hypoechoic sonographic,and calcification was found in 3 cases,and 3 cases showed heterogeneous and high enhancement by CEUS.1 case of urachal abscess showed untypical ultrasonographic features was misdiagnosed as bladder cancer.1 case of urachal diverticulum was diagnosed correctly by characteristic location and typical ultrasonographic findings.2 cases of urachal mucinous cystadenoma exhibited solid hypoechoic nodules with clear boundary and homogeneous echo at the anterior wall of bladder,showing poor blood supply by CEUS. Conclusion Urachal disease has special features of ultrasonography,CEUS can identify the character and invasive range of lesions, and improve the diagnostic accuracy.Therefore, ultrasonography has an important clinical value.