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脾臟周圍之肝左葉舌狀節－超音波偵查
Perisplenic Lingular Segment of Left Hepatic Lobe-Sonographic Detection
摘要
隨著超音波及電腦斷層廣泛地使用，脾臟周圍之肝左葉舌狀節(PSLS)，並非罕見。在一個月內共有1,000例接受上腹部超音波檢查的患者，以弧型及扇型超音波併3.5MHz-5.0MHz頻率之探頭，進行脾臟掃描時，當發現脾臟上方（頭側）或外圍有低回音之實質性構造，如果能證實其與肝臟相連，有門靜脈分支在內，且非為積液，即可視為PSLS。 結果顯示：PSLS約佔3.3%，男性與女性出現之比例相近。其回音強度與脾臟相比，絕大多數低於脾臟(87.9%)；少數則呈兩者相等(9.1%)或高於脾臟(3.0%)。 本研究觀察發現：對於PSLS而言，肝臟左葉明顯被覆於脾臟上方或外側，使得脾臟與肝臟回音強度得以直接比較；此時脾臟回音強度大多較PSLS為高。PSLS並非罕見，應防將其誤以為橫膈膜下膿瘍或脾臟被膜下血腫，而作不必要的引流術或外科手術。
並列摘要
The wide application of ultrasonography and computed tomography has enabled the identification of the perisplenic lingular segment of left hepatic lobe (PSLS). Within a period of one month, we examined 1,000 patients with upper abdominal sonography. Usually a vector or sector scanner with 3.5MHz to 5.0MHz transducer was used for the splenic ultrasonographic scanning. PSLS was defined as a crescent hypoechoic solid structure cephalic and/or lateral to the spleen, and contiguous to liver, with presence of portal vein radicles but without perisplenic fluid collection. The results showed that PSLS occurred in 3.3% of cases, with similar incidences in male and female (3.3%: 3.4%). As for the echogenicity the PSLS was less echogenic than the spleen in 87.9% of patients, isoechoic in 9.1%, and hyperechoic in 3%. Therefore PSLS is not a rare condition, that should be kept in mind for differential diagnosis from subphrenic abscess, subcapsular hematoma and for decision of interventional management.
延伸閱讀
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