肠脂垂炎的超声及超声造影表现  

Ultrasound and Contrast-Enhanced Ultrasound Findings of Epiploic Appendagitis

作　　者：杨帆[1] 刘静媛 陈媛[1] 雷建美 俞玲芳 吴火林 YANG Fan;LIU Jingyuan;CHEN Yuan;LEI Jianmei;YU Lingfang;WU Huolin(Department of Ultrasound,the 907th Hospital of Chinese People’s Liberation Army Joint Logistic Support Force,Nanping 353000)

机构地区：[1]中国人民解放军联勤保障部队第九〇七医院超声科,福建南平353000

出　　处：《中国医学影像学杂志》2024年第12期1256-1259,共4页Chinese Journal of Medical Imaging

基　　金：第九〇七医院院管课题项目(907KT202202)。

摘　　要：目的 探讨肠脂垂炎(EA)的超声及超声造影表现。资料与方法 回顾性选取2016年5月—2023年5月在联勤保障部队第九〇七医院确诊的EA患者23例,分析其常规超声和超声造影表现,并对其后续超声表现的演变情况进行随访。结果23例患者均可见结、盲肠旁单发肿物,呈卵圆形11例、椭圆形8例、不规则形4例。15例肿物边界清晰,其中12例肿物周边可见线样低回声包绕;23例肿物均表现为实性高回声团,其中2例内部回声欠均匀,可见条纹状低回声区;3例肿物相邻肠壁可见轻度增厚;19例肿物与前腹壁粘连,位置固定;23例肿物内均未见明显血流信号,仅5例肿物周边可见少许血流信号。10例患者行超声造影检查,其共同表现为:肿物中央全程未见造影剂灌注,呈无增强;肿物边缘可见造影剂进入,呈环状高增强,其厚度约0.20~1.50 cm。12例患者接受超声复查显示在随访期间,7例患者原有肿物完全消失,其中1例在子宫直肠窝发现有腹腔内游离体,另5例肿物体积均不同程度缩小。结论 EA的超声造影特征为中央坏死区为无增强,边缘呈环形高增强,超声造影能直观显示梗死肠脂垂的大小和范围,可为临床确诊EA提供有力的影像学证据。Purpose To investigate the conventional ultrasound and contrast-enhanced ultrasound features of epiploic appendagitis(EA).Materials and Methods A retrospective study was performed on 23 patients who were diagnosed with EA in the 907th Hospital of Chinese People’s Liberation Army Joint Logistic Support Force from May 2016 to May 2023.The conventional and contrast-enhanced ultrasound findings were analyzed,and the subsequent evolution of ultrasound findings were followed up.Results All 23 patients presented with a solitary mass adjacent to the colon or cecum,with eleven masses being oval,eight being elliptical and four irregular in shape.The margin of the mass was clear in 15 cases,with 12 cases showing a linear hypoechoic rim around the mass.All 23 masses appeared as solid hyperechoic lesions,with two cases showing internal inhomogeneous echoes and linear hypoechoic areas,three cases showing mild thickening of the adjacent intestinal wall and 19 cases showing adhesion to the anterior abdominal wall and fixed in position.No obvious blood flow signals were detected inside the masses in all 23 cases,while only five cases showing slight blood flow signals around the mass periphery.Contrast-enhanced ultrasound demonstrated that the central part of the mass did not enhance,while the edge of the mass showed a ring-shaped hyperenhancement with a thickness of approximately 0.20-1.50 cm in ten patients.Follow-up ultrasound examinations were performed in 12 patients,and the results showed that seven patients had complete disappearance of the initial mass,with one patient found to have a loose body in the rectouterine pouch,and the volume of the mass in the remaining five patients showed varying degrees of reduction during the follow-up period.Conclusion The characteristics of contrast-enhanced ultrasound in EA include a central necrotic area without enhancement,showing a ring-shaped enhancement at the edge.Contrast-enhanced ultrasound is a highly effective imaging modality that can provide strong evidence for the clinical

关 键 词：肠脂垂炎 超声检查 造影剂 诊断 鉴别 

分 类 号：R574.62[医药卫生—消化系统] R445.1[医药卫生—内科学]