彩超在诊断肠旋转不良中的应用

摘要

Objective To investigate the use of color Doppler sonography in the diagnosis of malrotation in infants. Methods 19 postoperative malrotation cases were investigated retrospectively and 12 infants suspected with malrotation from 1997 to August 2000 were investigated prospectively with color Doppler songography to determine the relationship between the SMV(Superior Mesenteric Vein) and the SMA(Superior Mesenteric Artery) and the “whirlpool sign” .Results 15 of the 19 postoperative and 10 of 12prospective infants were found to have abnormal relationship between the SMV and SMA. 8 of the 12infants were found to have “whirlpool sign” All the malrotation and midgut volvulus were confirmed at operations Conclusions The diagnosis of intestinal malrotation and midgut volvulus with color Doppler sonography was a reliable supportive modality, which were easy to do and non-traumatic, with good sensitivity and specialty and without X-ray exposure.%目的肠旋转不良合并中肠扭转是严重的急腹症，需要及时诊断及早手术。文献报道彩超检查肠系膜上静脉(SMV)与肠系膜上动脉(SMA)，依据它们的位置变化及有无“漩涡征”(whirlpool sign)可以确诊。为了证实彩超检查对肠旋转不良患儿的诊断价值而进行了病例观察。方法对19例肠旋转不良术后的患儿进行回顾性B超检查；自1997～2000年8月对12例因呕吐胆汁样液的≤2个月婴儿进行了术前的彩超检查，确定SMV与SMA的关系，部分病例同时作了消化道造影。结果19例回顾性检查中15例SMV与SMA关系异常；前瞻性术前彩超检查组10例SMV与SMA关系异常，其中8例有“漩涡征”。结论彩超检查能够快速、无创、比较准确的诊断肠旋转不良及其合并的中肠扭转。