膈疝的临床影像学诊断  

The diagnosis of clinical image of the diaphragm hernia

作　　者：谭秀钟[1] 程传虎[1] 蓝博文[1] 王革[1] 陈伟明[1] 李勇生[1] 

机构地区：[1]广东省惠州市中心人民医院,广东惠州516001

出　　处：《海南医学》2005年第9期35-37,8,共4页Hainan Medical Journal

摘　　要：目的加深对膈疝的临床X线和CT征象的认识及影像检查方法的选择。方法回顾分析31例经手术证实的膈疝的X线或CT表现。结果见下列征象①膈面异常:膈面轮廓部分或全部不清与缺如;假“膈面”升高;膈上半圆形块状阴影;跨膈肌阴影。②胸腔积气积液阴影或块状影:中下肺野囊状、或蜂窝状透光阴影;胸腔大气液平面;心膈角区块状影。③胸腔阴影形态的可变性:不同时间、不同体位阴影的形态、数量或密度发生改变。④邻近脏器的异常:纵隔向健侧移位;腹部正常脏器的上移位或缺如。⑤钡餐(或泛影葡胺)及钡灌肠检查胸腔内见胃肠道。⑥人工气腹检查见气胸。⑦CT扫描胸腔内见胃肠道、网膜及肠系膜、肝脾肾。结论胸腹部X线平片或透视、钡餐(泛影葡胺)或钡剂灌肠检查、人工气腹检查及胸部上腹部CT扫描对膈疝的术前诊断有重要价值。胸腹部平片及透视对膈疝有提示作用,钡餐(钡灌肠)能直接显示胸腔内胃肠道,胸腹部CT扫描(尤其增强扫描)能清晰显示疝入胸腔的空腔性或实质性脏器、受压或发育不全的肺叶及发育不良的肺动脉。Objective Strengthen the clinical cognition of X-ray and CT sign of the diaphragm hernia and choice of the inspection method of the image Methods look back sex analytical 31 example the X-my or the performance of CT of the diaphragm hernia confirm by surgical operation Results See the following signs ①The unusual diaphragm： Diaphragm outline part or complete unclear and scarce; the rise of the false diaphragm; Semi-circular cubic shade on the diaphragm and agglomeration shade; stride diaphragm skin shade. ②Thethorax＇s accumulating gas and liquid shadow or agglomeration shadow： or agglomeration shadow： mid-lower half wild lung theca, or alveolate euphoric shadow; heart diaphragm angle block form shadow. ③ Changeability of the thorax shade form ： The form , quantity or density of different rime , different shade of body posturechange. ④ The ones that are near the internal organs are unusual ： The mediastinum shifts towards the side;The normal internal organs of the belly shift up or the scarce. ⑤ Barium meal （or injecting into extensive shadow grape amine through stomach tube ） and barium enema check thorax of seeing stomach and intestines way.⑥ The artificial pneumoperitoneum check of seeing pneumoperitoneum. ⑦ CT thorax scans of seeing stomach and intestines way, network membrane and mesenterium , liver spleen kidney form in the thorax. Conclusions Chest belly X-ray flat sections for microscopic examination, perspect, barium meal （or extensive shadow grape amine） check, barium pharmaceutical enema check, artificial pneumoperitoneum check and chest upper abdomen CT scan is important value to diagnose of diaphragm hernia before the operation. Chest belly flat seetions for microscopic examination and perspect has prompt function to diaphragm hernia, the barium meal （barium enema） can show the stomach and intestines way in the thorax directly , chest belly CT scanning （especially strengthen scan） can show clearly that the hemia entering the cavity in the thorax and substantiv

关 键 词：先天性膈疝 创伤性膈疝 放射线摄影术 X线 CT诊断 

分 类 号：R445[医药卫生—影像医学与核医学]