胃充盈声学造影在诊断先天性肥厚性幽门狭窄中的应用  

Applications of Stomach Full Acoustic Imaging in the Diagnosis of Congenital Hypertrophic Pyloric Stenosis

作　　者：马穗红[1] 柳建华[1] 马晓梅[2] 罗环千[3] 萧淑宜[1] 区文财[1] 

机构地区：[1]广州市第一人民医院超声科,广东广州510180 [2]深圳市宝安区西乡人民医院超声科,广东深圳518102 [3]东莞市人民医院超声科,广东东莞523059

出　　处：《中国医学影像学杂志》2013年第10期758-760,764,共4页Chinese Journal of Medical Imaging

基　　金：广州市科技计划项目(2009Z1-E381)

摘　　要：目的探讨胃充盈声学造影在诊断先天性肥厚性幽门狭窄中的意义。资料与方法44例先天性肥厚性幽门狭窄患儿行胃肠充盈声学造影检查，测量幽门管内径及幽门管前后壁的各黏膜层厚度，观察造影剂在凼门管腔缝隙间的流动情况。结果在声学造影剂衬托下，可以更清晰地显示胃壁及幽门管黏膜的细致结构，可见幽门管中段肌层最厚，黏膜层靠近胃窦部水肿增厚更明显；测得幽门管内径平均为（1．95±0．35）mm：造影剂通过幽门管的首次时间：16例在5min内，19例5～10min，9例观察20min仍未见明显通过；在20min的观察期内，13例造影剂通过幽门管5次以上，22例1～5次，9例未见明显通过。结论胃内充盈声学造影检查可以清晰细致地观察幽门管的结构特征和胃内液体通过幽门管的流体动力学表现，对手术治疗和疗效评价具有重要指导意义。Purpose To explore the significance of stomach full acoustic imaging in the diagnosis of congenital hypertrophic pyloric stenosis （CHPS）. Materials and Methods 44 cases of CHPS children underwent gastrointestinal filling acoustic contrast imaging. diameter and mucous layer thickness of the front and rear walls of the pyloric tube were measured, the contrast agent flow between the pyloric lumen gaps was observed. Results With the backdrop of the ultrasound contrast agent, delicate structure of the stomach and pyloric mucosa could be more clearly observed, it was shown that muscular layer in the middle of pyloric tube was thickest and mucosal layer edema and thickening was more obvious near the antrum; internal diameter of pyloric tube was （1.95 ±0.35） mm; first pass time of the contrast agent through the pyloric tube： within 5 rain in 16 cases. 5-10 min in 19 cases, while clear pass through still could not be observed by 20 minutes in 9 cases： during the 20 minutes observation, contrast agent passed through the pyloric tube for 5 times or more in 13 cases, 1 to 5 times in 22 cases, while 9 cases showed no obvious pass. Conclusion Stomach full acoustic imaging enables clearly and detailed observation of the structural characteristics of the pyloric tube and hydrodynamic manifestation of the stomach liquid when passing through the tube, thus is significantly important for surgical treatment and efficacy evaluation.

关 键 词：幽门狭窄 肥厚性 先天畸形 超声检查 多普勒 彩色 造影剂 儿童 

分 类 号：R537.6[医药卫生—内科学] R445.1[医药卫生—临床医学]