小兒腸套疊－超音波診斷之特性

ULTRASOUND DIAGNOSIS OF INTUSSUSCEPTION IN INFANCY AND CHILDHOOD

許居誠(Giu-Chen Hseu) ； 李三剛(San-Kan Lee) ； 周定遠(Ting-Ywan Chou) ； 龔敏凱(Mein- Kai Gueng and Peter) ； 何善平(S. P. Ho.) ； 余昌遺(Chang-Yi Yu) ； 林光大(Kuang-Tah Lin)

《中華放射線醫學雜誌》 12卷4期 (1987/12) Pp. 383-388

摘要

超音波掃描對於腸套疊的診斷價值，早已獲得肯定。本院於過去兩年間有15例症狀非典型的腸套疊病例造成診斷的困擾，後經由腹部超音波掃描發現類似“甜圈圈”或“假腎”徵象而獲得診斷，並接受鋇鹽灌腸加以證實。結果共有6例灌腸復位成功，其“甜圈圈”和“假腎”徵象之低囘音環厚度小於5 mm者有3例，而大於16 mm的8例中僅有2例灌腸復位成功。我們囘顧分析這15例的超音波徵象，比較鋇鹽灌腸的結果，並參考文獻報告後認為，超音波掃描應該作為所有臨床疑似腸套疊病患的首要篩檢工具，因為（1）它是早期診斷非典型症狀病例的有利依據。（2）作為不適於鋇鹽灌腸檢查，如：已有腹膜炎或敗血症等跡象病例的診斷工具。（3）自患者病灶的“甜圈圈”和“假腎”徵象中低囘音之厚度可預估鋇鹽灌腸復位的難易程度。（4）對重複發作的病例，超音波不僅提供診斷且可監視使用水溶性對比劑試行灌腸復位的情形。（5）可同時檢視腹部其餘器官是否有病變發生。

並列摘要

Intussusception is a common problem in children under the age of 2 years. The diagnosis of intussusception is suspected clinically and is accomplished on the basis of intermittent abdominal pain, vomiting. palpable abdominal mass and blood in the stools. But in those cases with atypical clinical presentation, the diagnosis may not be as strongly considered. Ultrasonography has been proven to be valuable in the detection of intussusceptions, In a retrospective analysis of the sonographic images of 15 cases of intussusception, we found that ultrosound not only establishes the diagnosis quickly, but also provides information concerning potential reducibility of the lesion. In our hospital, we have come to the conclusion that ultrasound should be the first imaging madality in cases of suspected intussusception.