膈疝胸部X线征象与钡餐造影应用价值  

Explore diaphragmatic hernia chest X-ray signs and barium meal application value

作　　者：李善义[1] 许德辉[1] 王杰[1] 李大刚[1] 韩标[1] 

机构地区：[1]太和县中医院放射科,236604

出　　处：《安徽医学》2012年第11期1529-1532,共4页Anhui Medical Journal

摘　　要：目的探讨膈疝的胸部X线征象及钡餐造影应用价值,对胸部X线检查出现误诊漏诊病例进行原因分析。方法回顾分析22例患者经钡餐造影和部分手术证实为膈疝的胸部X线征象及钡餐造影表现。结果膈疝具有下列征象:①膈面异常:膈面轮廓不清,假膈面升高;②胸腔纵隔心影重叠区异常阴影:膈上囊状影或团块影(可含气、液平面),且与膈肌不易分开;胸腔宽大气液面;胸部侧位见心后食管走形区大小不一的囊状影或肿块影;下肺野心膈角区囊状影;胸骨后前肋膈角区团块影;单侧肺野蜂窝状透亮影;③胸腔阴影形态的可变性:不同时间、不同体位阴影的形态、密度及内容物可发生变化;④临近脏器异常:纵隔向健侧移位,腹腔脏器上移位;⑤钡餐造影发现钡剂进入胸腔阴影内。结论单纯胸部X线征象可以高度提示膈疝的诊断,钡餐造影对明确膈疝的诊断有重要诊断价值。Objective To explore the signs of diaphragmatic hernia chest X-ray and the application value of barium meal,in order to further deepen the understanding of the signs of diaphragmatic hernia chest X-ray and the performance of barium meal,and also to analyze the causes of the misdiagnosed cases of chest X-ray diagnosis.Methods Retrospective analysis was conducted for the diaphragmatic hernia chest X-ray signs and barium meal performance in 22 patients after a barium meal and partial surgery confirmation.Results Diaphragmatic hernia signs were as follows： ①diaphragmatic surface outline was not clear and false diaphragmatic surface increased;②there was diaphragm shadow or cystic mass shadow（with gas or liquid square）,with the diaphragmatic muscle not easy to separate,and wide atmosphere liquid surface in chest;there was cystic shadow in cardio-diaphragmatic area in the lower lung field;there was mass shadow in the substernal anterior rib septal area;there was a honeycomb of bright shadow in unilateral lung field;③ the variability of chest shadow： the shape,density and content of the shadow could be changed in different time and different position;④ the adjacent viscera abnormality： there was a shift of mediastinum to normal side and an upward shift of intra-abdominal organs;⑤barium was found to enter into shadows of chest in the barium meal.Conclusion Pure chest X-ray signs can be highly suggestive of diaphragmatic hernia diagnosis;barium meal has important diagnostic value in specific diaphragmatic hernia diagnosis.

关 键 词：膈疝 胸部X线征象 钡餐造影表现 

分 类 号：R816.4[医药卫生—放射医学]