儿童嗜酸性胃肠炎的超声表现

摘要

Objective To summarize the manifestation of pediatric eosinophilic gastroenteritis by ultrasound and discuss the diagnostic value of ultrasonography in pediatric eosinophilic gastroenteritis. Methods The ultrasonic appearances of 31 cases of pediatric eosinophilic gastroenteritis confirmed by clinics and pathology were reviewed and analyzed. Results Nineteen of 31 cases were observed in association with eosinophilic infiltration of other organs which were diagnosed as idiopathic hypereosinophilic syndrome.Eosinophilic cystitis was the most common among the complications(89.4%,17/19).Twelve of 31 cases were diagnosed as eosinophilic gastroenteritis without complications.The endoscopic appearances of eosinophilic gastroenteritis were nonspecific which include erythematous,hyperemia edema,and partiality erosion changes.Endoscopy demonstrates increased numbers of eosinophils in the propria of stomach and the duodenum.Ultrasound features of the gastroenteritis appeared diffuse or the parts of gastrointestinal tract.The most common sites of eosinophilic gastroenteritis were the stomach and duodenum.Involvement of muscle layer and serosal layer showed wall thickening of cyclic annular and uniformity.Ultrasound might show nodular or irregular thickening of the folds in the gastric antrum when the submucosa were thickening.The mucosal layer involvement was not easy to be found by ultrasound.The echo of serous layer and submucosa associated with the disease stage.The thickening of surrounding omentum and mesenteric tissue,echo enhancement and nonspecific hyperplastic mesenteric lymph nodes infiltrated with eosinophils might be present.Eosinophilic ascites could often be detected.Conclusions Ultrasound has obvious advantages in the diagnosis of pediatric eosinophilic gastroenteritis,and the ultrasonic changes of pediatric eosinophilic gastroenteritis are characterized.Ultrasonography can provide the possible diagnosis when combined with inflammatory of other organs,especially cystitis inflammatory changes.%目的 总结儿童嗜酸性胃肠炎的超声表现,探讨超声对儿童嗜酸性胃肠炎的诊断价值.方法 回顾性分析经病理和临床证实的31例嗜酸性胃肠炎患者,对其超声表现进行总结.结果 31例嗜酸性胃肠炎患者中,19例合并其他器官受累,诊断特发性嗜酸性粒细胞增多综合征,最常见的合并症为嗜酸性膀胱炎(89.4%,17/19);12例无其他系统合并症.内窥镜检查表现为黏膜充血水肿、红斑、部分可见糜烂面的非特异性表现.组织活检均可见胃、十二指肠固有层嗜酸性粒细胞浸润.超声检查显示胃肠道壁弥漫性或部分性增厚,病变以胃及十二指肠最为常见,浆膜层及固有肌层环状均匀增厚为其特征性改变.胃窦区黏膜下层增厚可使局部皱襞明显粗大,呈向腔内的结节状突起.黏膜层增厚不明显.浆膜层与黏膜下层回声与病程相关.病变区周围网膜及系膜增厚、回声增强,可见肠系膜淋巴结非特异性增大,腹水为常见的征象.结论 儿童嗜酸性胃肠炎超声改变有一定的特征性,如同时发生膀胱炎或其他器官的炎症改变,超声可以提示诊断嗜酸性胃肠炎.