目的 探讨胸壁、腹壁寒性脓肿声像表现及特征,提高超声对胸壁、腹壁寒性脓肿的诊断.方法 回顾9例临床确诊的胸壁、腹壁寒性脓肿,根据声像表现分型,计算其占比,并分析声像共性特征.结果 实性低回声型:胸壁1例,占11.11％;液性回声型:胸壁1例,腹壁2例,占33.33％;混合回声型:胸壁3例,腹壁2例,占55.6％.声像共性特征表现为胸壁、腹壁病灶肌层均有破坏,形成低回声窦道,走行可迂曲,由病灶基底或旁边向胸膜或腹膜伸展与胸腔或腹腔内病灶相连,加压可见液性或类液性回声通过窦道缓慢流入胸腔或腹腔病灶.结论 超声能清晰显示寒性脓肿对胸壁、腹壁肌层的破坏,提供窦道的走向及病灶范围,其对胸壁、腹壁寒性脓肿的诊断有较高的实用性及准确性.%Objective To explore the ultrasonic manifestation and characteristics of the psychrapostema of chest and abdominal wall,and improve the ultrasonic diagnosis of the disease. Methods Retrospective analysis was performed in 9 patients clinically diagnosed with psychrapostema of chest and abdominal wall,which were classified by ultrasonic manifestation followed by calculation of the proportion for each type. Results Solid-hypoecho type:1 patient in chest wall,accounted for 11.11％;fluid-echo type:3 patients with 1 in chest wall and 2 in abdominal wall,accounted for 33.33％;mixed-echo type:5 patients with 3 in chest wall and 2 in abdominal wall,accounted for 55.6％. The common features of ultrasonic manifestation included damages in the muscular layer of the lesions with the formation of tortuous low-echo sinus tract,which stretched from the basal or peripheral areas of the lesion to pleura or peritoneum and was linked to the lesions inside thoracic or abdominal cavity fluid or semi-fluid echo was observed with increased pressure,which flowed slowly from sinus tract to the lesions in thoracic or abdominal cavity. Conclusion Ultrasound test can clearly manifest the damages of psychrapostema to the muscular layers of chest and abdominal wall and provide the sinus tract direction and range of lesions,which serves as a highly practical and precise tool for the diagnosis of psychrapostema in chest and abdominal wall.
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