腹部超声波
腹部超声波检查 | |
---|---|
ICD-9-CM | 88.76 |
OPS-301 | 3-059 |
MedlinePlus | 003777 |
腹部超声波是一种医学超声波检查,用于检查人体腹部。在病人腹部涂上超声波导电凝胶后,超声波探头发出的声波就能穿透腹部表面的腹壁,到达各器官。超声波探头将从器官反射的超声波收集分析后,便能产出腹部影像。因此,这项检查也被称为跨腹超声波,与直接将探头以内窥镜方式放入人体中空器官的内镜超声波有所不同。
腹部超声波检查通常由肠胃科、内科或放射科医生进行,亦可由超声波技师进行。
用途
[编辑]腹部超声波可用于判断不同体内器官的异常,例如肾脏[1]、肝脏、胆囊、胰脏、脾脏、腹主动脉等。如果超声波仪器有多普勒超声波功能,还可以检查血管中的血液流动状况,协助诊断肾动脉狭窄等疾病。此外,腹部超声波亦常用于检查怀孕妇女的子宫与胎儿;这类检查称为产科超音波[2][3]。
当病患出现腹痛或急性腹痛,腹部超声波可用于诊断病者是否患上阑尾炎及胆囊炎,以便安排紧急手术[4][5]。
当医生怀疑腹部器官可能异常胀大时,也会进行腹部超声波检查。能发现的病症包括腹主动脉瘤、脾脏肿大、尿潴留等。诊断为腹主动脉瘤的标准是:腹主动脉(以最外层计算)的直径超过3厘米,即为腹主动脉瘤[6]。
脾脏肿大是传染性单核白血球增多症的常见症状。腹部超声波可以协助检查患上此症者的状况[7],但由于正常人体脾脏的大小差异很大,超声波只应用于协助诊断脾脏肿大,而不应作为诊断的唯一依据,也不应仅依据超声波结果来决定病者是否适合恢复运动[7]。
腹部超声波也用于检查肾脏功能异常、胰脏消化酶(如淀粉酶、胰脏脂酶)功能异常的病人。
结石检查
[编辑]超声波能发现体内的结石,包括肾石、胆结石等。由于结石会吸收超声波,影像上将看到结石的后方出现黑色阴影。[8]
超声波亦可用于导引不同治疗程序,如导引体外震波、针刺活检及腹部穿刺引流(通过针刺从腹腔中抽走积水的治疗)等等[9]。
肝脏
[编辑]腹部超声波有助诊断肝功能指数异常的原因。超声波图像中可以看到的异常包括肝肿大[11]、反射增强(可能由胆汁郁积所致)[12]、胆囊或胆管病症、肝脏肿瘤等[13]。
肾脏超声波
[编辑]肾脏超声波是诊断与跟进肾脏疾病的重要常用工具。肾脏超声波的图像清晰,而且大部分肾脏病变都能在超声波图像中识别出来。[14]
技术特点
[编辑]腹部超声波的优点包括:方便快捷、可直接在病床边进行检查、不需使用对人体(特别是孕妇)有危害的X光、相比其他腹部造影检查(如电脑扫描)便宜等等[15]。但一个主要缺点则是,如果病人肠道内有大量气体,或腹部脂肪较多,将难以进行检查,影像的品质也不好[16]。此外,检查中能否获取满意的超声波影像,相当依赖进行检查的医护人员的经验与技术水平[17]。
腹部超声波的影像在检查时就可以即时看到[18],进行检查时也不须麻醉,所以可以通过移动探头来检查病人的反应[19]。例如,将探头按在病人的胆囊上,如果病人感到痛楚,即可能是患上急性胆囊炎[20]。
超声波能够穿透腹壁,检查骨盆内的器官与组织,例如膀胱、卵巢、子宫等。水是超声波极佳的传导媒介,所以检查这些器官前,会请病人大量喝水,让膀胱尽量胀大,以便超声波讯号穿透[21][22]。
参考资料
[编辑]- ^ Bisset. Differential Diagnosis in Abdominal Ultrasound, 3/e. Elsevier India. 2008-01-01: 257 [2011-04-10]. ISBN 978-81-312-1574-6.
- ^ Whitworth, M; Bricker, L; Mullan, C. Ultrasound for fetal assessment in early pregnancy. Cochrane Database of Systematic Reviews. 2015, (7): CD007058. PMC 4084925 . PMID 26171896. doi:10.1002/14651858.CD007058.pub3.
- ^ Salomon, LJ; Alfirevic, Z; Bilardo, CM; Chalouhi, GE; Ghi, T; Kagan, KO; Lau, TK; Papageorghiou, AT; Raine-Fenning, NJ; Stirnemann, J; Suresh, S; Tabor, A; Timor-Tritsch, IE; Toi, A; Yeo, G. ISUOG Practice Guidelines: performance of first-trimester fetal ultrasound scan (PDF). Ultrasound Obstet Gynecol. 2013, 41: 102–113 [2015-05-12]. PMID 23280739. doi:10.1002/uog.12342 . (原始内容 (PDF)存档于2015-09-06).
- ^ Puylaert, Julien B.C.M.; Rutgers, Peter H.; Lalisang, Roy I.; de Vries, Bas C.; van der Werf, Sjoerd D.J.; Dörr, Joep P.J.; Blok, Roeland A.P.R. A Prospective Study of Ultrasonography in the Diagnosis of Appendicitis. New England Journal of Medicine. 1987-09-10, 317 (11): 666–669. ISSN 0028-4793. PMID 3306375. doi:10.1056/NEJM198709103171103.
- ^ Ultrasonography by emergency physicians in patients with suspected cholecystitis. The American Journal of Emergency Medicine. 2001-01-01, 19 (1): 32–36 [2021-09-13]. ISSN 0735-6757. doi:10.1053/ajem.2001.20028. (原始内容存档于2021-09-13) (英语).
- ^ 6.0 6.1 Timothy Jang. Bedside Ultrasonography Evaluation of Abdominal Aortic Aneurysm - Technique. Medscape. 2017-08-28.
- ^ 7.0 7.1 American Medical Society for Sports Medicine, Five Things Physicians and Patients Should Question, Choosing Wisely: an initiative of the ABIM Foundation (American Medical Society for Sports Medicine), 24 April 2014 [29 July 2014], (原始内容存档于2014-07-29), which cites
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- Spielmann, AL; DeLong, DM; Kliewer, MA. Sonographic evaluation of spleen size in tall healthy athletes.. AJR. American Journal of Roentgenology. 2005-01, 184 (1): 45–9. PMID 15615949. doi:10.2214/ajr.184.1.01840045.
- ^ Dunmire, Barbrina; Harper, Jonathan D.; Cunitz, Bryan W.; Lee, Franklin C.; Hsi, Ryan; Liu, Ziyue; Bailey, Michael R.; Sorensen, Mathew D. Use of the Acoustic Shadow Width to Determine Kidney Stone Size with Ultrasound. Journal of Urology. 2016-01, 195 (1): 171–177 [2021-09-12]. doi:10.1016/j.juro.2015.05.111.
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- ^ Christoph F. Dietrich; Carla Serra; Maciej Jedrzejczyk. Ultrasound of the liver - EFSUMB – European Course Book (PDF). European federation of societies for ultrasound in medicine and biology (EFSUMB). 2010-07-28 [2017-12-22]. (原始内容 (PDF)存档于2017-08-12).
- ^ Childs, Jessie T; Esterman, Adrian J; Thoirs, Kerry A; Turner, Richard C. Ultrasound in the assessment of hepatomegaly: A simple technique to determine an enlarged liver using reliable and valid measurements: Ultrasound in the assessment of hepatomegaly. Sonography. 2016-06, 3 (2): 47–52 [2021-09-13]. doi:10.1002/sono.12051. (原始内容存档于2021-09-13).
- ^ Di Serafino, Marco; Gioioso, Matilde; Severino, Rosa; Esposito, Francesco; Vezzali, Norberto; Ferro, Federica; Pelliccia, Piernicola; Caprio, Maria Grazia; Iorio, Raffaele; Vallone, Gianfranco. Ultrasound findings in paediatric cholestasis: how to image the patient and what to look for. Journal of Ultrasound. 2020-03, 23 (1): 1–12 [2021-09-13]. doi:10.1007/s40477-019-00362-9. (原始内容存档于2022-03-14).
- ^ Janice Hickey, Franklin Goldberg. Ultrasound review of the abdomen, male pelvis & small parts. Philadelphia : Lippincott. 1999. ISBN 0397516916.
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