腔内超声造影在术前难诊断性克罗恩病腹腔瘘中的应用  

Value of intracavitary contrast-enhanced ultrasound via abdomen in fistulas difficult to diagnose before operation

作　　者：陈瑜君[1] 毛仁[2] 谢晓华[1] 田文硕[1] 徐明[1] 陈淑玲[1] 陈旻湖[2] 谢晓燕[1] Chen Yujun Mao Ren Xie Xiaohua Tian Wenshuo Xu Ming Chen Shuling Chen Min-hu Xie Xiaoyan(Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China Department of Gastroenterology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Chin)

机构地区：[1]中山大学附属第一医院超声医学科,中山大学超声诊断与介入超声研究所,广州510080 [2]中山大学附属第一医院消化内科,广州510080

出　　处：《中国医师杂志》2017年第6期807-809,共3页Journal of Chinese Physician

基　　金：国家自然科学青年基金项目（81601514,81500501）

摘　　要：目的评估腔内超声造影新技术在术前难诊断性克罗恩病腹腔瘘中的应用。方法共入组12例术前据临床表现怀疑腹腔瘘但肠镜、CT／MR、膀胱镜等检查均未诊断腹腔瘘的克罗恩病患者，行腔内超声造影检查，经腹于腹腔脓肿处穿刺抽脓后注入稀释超声造影剂，在造影模式下观察瘘管的走向和与邻近脏器的关系。采用手术结果作为参考标准。结果通过腔内超声造影10例患者正确检测到瘘管，其中包括7例回肠瘘，2例回肠膀胱瘘，1例结肠瘘。本组研究中腔内超声造影诊断克罗恩病腹腔瘘的准确度为83．3％（10／12）。无一例腔内超声造影不良事件发生。结论腔内超声造影对术前难诊断性克罗恩病腹腔瘘的诊断率高，可以作为CT／MR小肠成像不满意时的替代方案。Objective To evaluate the value of intra-cavitary contrast-enhanced ultrasound （IC- CEUS） via abdomen in fistulas difficuh to diagnose before operation. Methods Clinical data of 12 patients with preoperative clinical suspicion of Crohn＇s Disease （CD） complications of fistula were enrolled in the study. Colonoscopy, cystoscope, or CT/MR has not confirmed the diagnosis of intra abdominal fistulas. IC- CEUS were performed by locally-injection of contrast agent in abdominal abscess, observing fistula and the relationship with the adjacent organs in CEUS mode. Diagnostic criteria were surgical findings. Results Fistulas in 10 patients were detected by IC-CEUS, including 7 cases of Ileo-mesenteric fistuls, 2 cases of il- eo-vesical fistulas, and 1 case of colo-vesical fistula. The accuracy rate of IC-CEUS in diagnosis of fistulas difficult to diagnose before operation in Crohn~ disease was 83.3% （10/12）. No severe adverse events oc- curred during and after IC-CEUS procedure. Conclusions Our preliminary study shows that IC-CEUS is feasible in detecting abdominal fistula with high accuracy. It might be used as the alternative imaging tech- nique for detecting fistulas when CT and MR are insufficient.

关 键 词：腔内超声检查 Crohn病/并发症/超声检查 瘘/并发症/超声检查 腹腔/病理学/超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学]