先天性胃窦隔膜超声图像特征分析

Ultrasonographic features of congenital gastric antrum septum in children

目的分析先天性胃窦隔膜患儿超声图像特征。方法选取我院经手术病理确诊的胃窦隔膜患儿24例,术前均行常规超声检查,8例加行胃充盈超声检查,分析其超声特征。结果超声确诊8例(33.33%),均经胃充盈超声检出。常规超声表现:未禁食前,2例因充盈胃内容物胃窦舒张时,隔膜仅表现为垂直于胃窦前后壁的窄条状低回声及胃窦局部缩窄;胃潴留18例(75.00%),幽门开放困难;3例伴有幽门肌层水肿增厚。胃充盈超声检查显示,2例表现为“高-低-高”三线回声结构,长0.80 cm、1.20 cm,厚0.18 cm、0.60 cm,2例见隔膜上小孔,呈中央型或偏心型,孔径大小0.13 cm、0.16 cm;6例表现为隔膜折叠、水肿增厚,呈瓣膜样或“乳头征”。结论先天性胃窦隔膜常规超声特征为垂直于胃窦前后壁的窄条状低回声、胃窦局部缩窄、胃潴留等,结合胃充盈后垂直于胃窦前后壁的窄条状三线回声、瓣膜样结构或“乳头征”,有望提高先天性胃窦隔膜的超声检出率。

Objective To investigate the ultrasonographic features of congenital gastric antrum septum in children.Methods Twenty-four children with gastric antrum diaphragm confirmed by surgery and pathology in our hospital were selected.Conventional ultrasonography was performed before operation,and gastric filling ultrasonography was performed in 8 cases,the ultrasonic characteristics were analyzed.Results Eight cases(33.33%)of gastric antral septum were accurately diagnosed by gastric contrast ultrasound.Conventional ultrasonic manifestations:2 cases presented as a narrow strip of low echo perpendicular to the anterior and posterior walls of gastric antrum,with local narrowing of gastric antrum,18 cases of gastric retention with narrowed pyloric opening,and 3 cases of thickening of pyloric muscle layer.Gastric filling ultrasonography showed 2 cases with“high-low-high”three line echo structure,which were 0.80 cm,1.20 cm in length and 0.18 cm,0.60 cm in thickness.2 cases of central or eccentric apertures,whose size ranged from 0.13 cm,0.16 cm,was observed in the diaphragm.Diaphragms in the empty gastric antrum looked like redundantly folded mucosa in 6 cases,which were edematous and thickened and with fixed shape,forming the“Nipple sign”.Conclusion The identification of“hyper-hypo-hyper”echogenicity strip structure,local narrowing of gastric antrum and gastric retention would be helpful in the initial screening of gastric antrum septum by routine ultrasound examination.