獭尾肝的超声表现及误诊分析.docVIP

精品论文 参考文献 獭尾肝的超声表现及误诊分析 湖南省长沙市第三医院 湖南长沙 410015 【摘 要】目的：探讨獭尾肝的声像图表现及分析其所致的误诊。方法：回顾性分析16例经影像学检查证实的獭尾肝的超声表现及7例被超声误诊病例产生的原因。结果：獭尾肝的声像图表现为脾周外侧的新月形实性团块，回声水平可等于、低于或稍高于脾脏，其内可见“=”样的特征性结构；在16例獭尾肝病例，经超声正确诊断的有9例，其中经过CT检查对照证实的有5例，经手术对照证实的有1例；超声误诊病例共7例；超声误诊但经CT检查证实为獭尾肝的有5例；超声误诊经手术证实为獭尾肝的有1例。结论：超声检查可以对獭尾肝作出正确的诊断，正确认识其声像图表现，可减少左肝外叶形态学变异所致的超声误诊 【关键词】獭尾肝；超声表现；误诊 Analysis of Ultrasonographic misdiagnosis and Ultrasonography in Otter tail liver [Abstract]Objective：To investigate the Otter Tail liver sonographic and analysis of misdiagnosis its due.Methods：A retrospective analysis of 16 patients with confirmed ultrasound imaging performance reasons otter tail liver and ultrasound is generated 7 cases of misdiagnosed cases.Results：The sonographic otter tail liver is crescent solid mass perisplenic outside，echo level may be equal to，or slightly lower than the spleen，seen in = kind of characteristic structure；in 16 otter tail liver cases，a correct diagnosis by ultrasound 9 cases，including through the control CT examination has confirmed 5 cases，there is one case confirmed by surgery controls；ultrasound misdiagnosed cases total of 7 cases；however misdiagnosed by CT examination confirmed otter tail liver there are 5 cases；misdiagnosed confirmed by surgery otter tail liver have one case.Conclusion：Ultrasonography can make the correct diagnosis on Otter Tail liver，correct understanding of its sonographic appearance，can reduce the left hepatic lobe morphological variation caused by ultrasound misdiagnosis 肝脏的解剖形态学个体差异很大，尤其是肝脏表面的沟、裂、切迹和突起及其变异在影像学中常致误诊，因此学习肝脏形态学变化的切面影像，对上腹部疾病的影像诊断有重要的意义[1]。獭尾肝（Otter tail liver）是一种肝脏正常解剖学变异（normal anatomic variants），它表现为左肝外叶细长，向人体左后方的延伸，并越过左侧腋中线到达脾脏的左侧，呈新月形包裹于脾左外侧方，甚至延伸到其后方（见图9），因此国内学者又将其称为之“包围肝”[2]，国外的文献将肝脏的这种解剖学改变称为肝薄片 [3]（silver of liver[4]）。獭尾肝是临床上并不少见的肝脏解剖学变异，有报道称可见于5%的成人[5]，在影像学上也有显而易见的表现，然而与之相关的影像学研究特别是超声检查方面的报道却不多。因为超声医师对其了解和关注较少，加之肝、脾声阻抗差异小，超声医师常将其误认为脾脏肿大、脾脏外侧肿块、脾膈下积液（血）；或将獭尾肝的病灶误认为脾脏源性病灶，如将獭尾肝内的囊性无回声结节误认为脾囊肿，獭尾肝内的稍