超声诊断儿童十二指肠疾病的临床应用进展

Progress in the clinical application of ultrasound in the diagnosis of duodenal diseases in children

十二指肠介于胃与空肠之间,大部分位于腹膜后,位置深且相对固定,这是区别于其他小肠节段的主要特点。儿童十二指肠相关疾病种类较多且病情复杂,具有与成人十二指肠明显不同的疾病谱,既包括先天性十二指肠闭锁或狭窄、肠旋转不良、环状胰腺、重复畸形等先天性疾病,又包括十二指肠壁炎症、壁间血肿、肿瘤等后天性疾病。X线、CT等检查方法可用于诊断儿童十二指肠相关疾病,但受电离辐射的影响,限制了其应用。超声检查具有无电离辐射、无创、高分辨率成像及实时动态观察等优点,非常适合儿童体型小、腹壁薄的特点。超声可实时动态识别整个十二指肠,清晰显示十二指肠肠腔、肠壁及肠外结构,详细分析其解剖结构,并识别和描述异常情况,对于儿童十二指肠相关疾病的诊断及鉴别诊断发挥重要作用。本文对超声检查在儿童十二指肠先天性及后天性疾病诊断中的应用进展进行综述,以期为儿童十二指肠疾病的临床诊断提供帮助。

The duodenum is located between the stomach and the jejunum,and most of it is located behind the peritoneum,the position is deep and relatively fixed,which is the main feature that distinguishes it from other small intestine segments.There are many kinds of duodenal related diseases associated with children and their conditions are complicated,and the disease spectrum is obviously different from duodenum of adults,including congenital duodenal atresia or stenosis,malrotation of intestine,annular pancreas,duplicate malformation and other congenital diseases.It also includes acquired diseases such as inflammation of duodenal wall,intermural hematoma and tumor.X-ray and CT can be used to diagnose children's duodenal related diseases,but their application is limited by the impact of ionizing radiation.Ultrasound examination has the advantages of non-radiation hazard,non-invasive,high-resolution imaging and real-time dynamic observation.It is very suitable for the characteristics of small size and thin abdominal wall in children.Ultrasound can dynamically identify the entire duodenum in real time,clearly show the duodenal lumen,intestinal wall and extraintestinal structure,analyze its anatomical structure in detail,and identify and describe abnormal conditions,which plays an important role in the diagnosis and differential diagnosis of duodenal-related diseases in children.This article reviews the application progress of ultrasonography in the diagnosis of congenital and acquired diseases of the duodenum in children,in order to provide help for the clinical diagnosis of duodenal diseases in children.