58例Meckel’s憩室病超声影像特点回顾性分析  

Retrospective Analysis of Ultrasound Imaging Characteristics of 58 Patients with Meckel's Diverticulum Disease

作　　者：张明智[1] 庄华[1] 罗燕[1] 

机构地区：[1]四川大学华西医院超声科,成都610041

出　　处：《生物医学工程学杂志》2014年第4期875-880,共6页Journal of Biomedical Engineering

基　　金：国家自然科学基金资助项目(81101061)

摘　　要：探讨表现为急腹症的Meckel’s憩室病（MD）的超声影像特点及诊断要点,回顾性分析了2009年1月-2012年5月急诊收治的58例经手术病理证实的MD的超声影像特点及其临床资料,并对其漏、误诊情况进行分析。结果提示,58例患者中,术前临床诊断为MD的21例,术中及病理发现MD炎合并急性阑尾炎14例,MD穿孔4例,MD并发肠套叠15例,MD并发肠梗阻14例,MD索带继发肠梗阻、肠坏死5例,无明显并发症MD 5例;急诊超声检查提示MD 8例、MD并发肠套叠1例,提示急性阑尾炎9例、肠套叠12例、肠梗阻12例、肠套叠并发肠梗阻2例,脐膨出、腹腔脓肿各1例。急诊超声提示MD的声像图表现为：脐周或右腹局部形态相对固定的肠管或者厚壁囊性团块,其一端与小肠相通或相连,一端为盲端。分析结果发现,MD超声检出困难（检出率为15.5%）,MD的并发症常表现为各种急腹症;急诊超声检查能很好地提示MD的各种并发症如肠套叠、肠梗阻、急性阑尾炎等（其检出率分别为24.1%、24.1%及15.5%）,因此对于表现为各种急腹症的MD,超声检查是简便、有效的一线影像手段,扫查时辅以恰当的手法,提高对憩室的发现率,对疾病的诊断和鉴别诊断具有重要意义。To evaluate the ultrasound imaging characteristics and diagnostic criteria for acute abdominal Meckel＇s diverticulum disease （MD）, we retrospectively analyzed the ultrasonic characteristics, clinical data of 58 cases of pathologically proved MD from January 2009 to May 2012. We found that among all the 58 patients, 21 patients were diagnosed with the preoperative clinical diagnosis of MD. Fourteen cases of MD inflammation with acute appendicitis were evaluated by pathological examinations after the surgery. We also found 4 cases of MD with perforation, 15 cases of MD with intussusceptions, 14 cases MD with intestinal obstruction, 5 cases of MD secondary to intestinal obstructionor intestinal necrosis, and 5 cases of MD without any obvious complications. Emergency ultrasound examinations revealed 8 cases of simple MD, 1 case of MD with intussusceptions, 9 cases of MD with acute appendicitis, 12 cases of MD with intestinal obstruction, 2 cases of MD with intussusceptions and intestinal obstruction, 1 case of MD with omphalocele and 1 case of MD with abdominal abscess. The emergency sonographic findings suggested that MD was relatively fixed bowel or thick-walled cystic mass, with one end connected to small intestine, and the other end connected to the blind side, at the periumbilicus region or at the lower right abdomen. A conclusion could be drawn that MD is difficult to be detected by ultrasound （detection rate was about 15.5 %）, and MD with complications such as intussusceptions, intestinal obstruction, acute appendicitis can usually be more easily detected （detection rates were 24.1%, 24.1% and 15.5%, respectively）. Sonography is a simple, effective way to make diagnosis and differential diagnosis of MD with different acute abdomen symptoms from other disease.

关 键 词：Meckel’s憩室 急诊 超声表现 临床表现 

分 类 号：R445.1[医药卫生—影像医学与核医学]