超声造影在胰腺外伤诊断及随访中的应用价值  

Application Value of Contrast-enhanced Ultrasound in the Diagnosis and Follow-up of Pancreatic Trauma

作　　者：梁彤[1] 石星[1] 梁峭嵘[1] 刘照宏[1] 黄春燕[1] 

机构地区：[1]广州中医药大学附属佛山市中医院超声科,广东省佛山市528000

出　　处：《中国超声医学杂志》2013年第11期1001-1003,共3页Chinese Journal of Ultrasound in Medicine

基　　金：广东佛山市科技局医学类科技攻关项目立项(No.201108073)

摘　　要：目的探讨超声造影在胰腺外伤诊断及随访中的应用价值。方法 46例胰腺外伤疑诊患者行常规超声及超声造影检查,并对确诊患者进行动态随访观察。结果 46例疑诊患者经手术或CT证实胰腺损伤37例,常规超声共检出29例,漏诊8例,诊断准确率约78.38%;超声造影检出35例,漏诊2例,诊断准确率约94.59%。37例确诊病例中,2例Ⅲ级及3例Ⅳ级损伤常规超声低估为Ⅱ级,1例Ⅲ级及2例Ⅱ级低估为Ⅰ级;而超声造影仅有1例Ⅲ级及1例Ⅳ级低估为Ⅱ级。其中23例行保守治疗,12例行手术放置支架引流,2例行部分切除术。1个月后14例Ⅰ级及5例Ⅱ级损伤痊愈,7例Ⅲ级及4例Ⅳ级损伤形成胰腺假性囊肿。6个月复查,9例胰腺假性囊肿消失,2例仍存在。结论超声造影能够明显提高胰腺外伤的诊断率并进行程度分级,通过动态随访,对发现并发症及判断预后有重要作用。Objective To explore the application value of contrast-enhanced ultrasound in the diagnosis and fol- low-up of pancreatic trauma. Methods 46 cases of patients with suspected pancreatic trauma were examined by con- ventional ultrasound（US） and Contrast-enhanced ultrasound （CEUS）, and the confirmed patients were implemented dynamical follow-up observation. Results In all 46 cases with suspected pancreatic trauma, 37 cases were confirmed by a operation or CT examination. In which, 29 cases were detected by the US, 8 cases were missed, the diagnostic accuracy was approximately 78.38~ ; 35 cases were detected by the CEUS, 2 cases were missed, the diagnostic accu- racy was approximately 94.59~/oo. In 37 confirmed cases, 2 cases of grade ]]I and 3 cases of grade IV trauma were un- derestimated by the US as grade ]] , 1 case of grade ]]I and 2 cases of grade lI were underestimated as grade I ; the CEUS, however, only underestimated 1 case of grade m and 1 case of grade IV as II level. In confirmed patients, 23 cases were implemented with conservative treatments, 12 cases were implemented with surgery for stent drainage, 2 cases were implemented with partial pancreatectomy. After 1 month, 14 cases of grade I and 5 cases of grade l] were healed, 7 cases of grade ]I[ and 4 cases of grade IV got pancreatic pseudocysts. 6 months later, in these 11 cases, the pancreatic pseudocysts of 9 cases disappeared, those of the remaining 2 cases still existed. Conclusions CEUS can sig- nificantly improve the diagnosis accuracy of pancreatic trauma and grading, moreover, the further dynamic follow-up has important significance for the detection of complications and the decision-making of prognosis.

关 键 词：超声检查 造影剂 胰腺 外伤 

分 类 号：R445.1[医药卫生—影像医学与核医学]