廖海珍　苏海庆　李业钊

[摘要] 目的 探讨脐尿管瘘的二维及彩色多普勒超声声像图特征及诊断价值。 方法 收集21例脐尿管瘘患者，所有病例均经手术证实，将临床资料与二维及彩色多普勒超声声像图特征一并做回顾性分析。 结果 经临床病理分析证实，超声诊断符合率86%，误诊率14%。18例超声诊断脐尿管瘘的声像图清晰，可见脐部与管状无回声或低回声相连，瘘管粗细不等，延伸至下腹腔，下段与膀胱相连。1例误诊为脐尿管窦道，2例误诊为脐炎。 结论 二维及彩色多普勒超声检查简便迅速，安全高效，可重复性强，可为临床诊断脐尿管瘘提供可靠的影像学依据，可作为诊断脐尿管瘘的首选影像学方法。

[关键词] 二维超声；彩色多普勒超声；脐尿管瘘；诊断

[中图分类号] R445.1 [文献标识码] B [文章编号] 1673-9701（2017）04-0119-03

The value of two-dimensional and color Doppler ultrasound in the diagnosis of urachal fistula

LIAO Haizhen SU Haiqing LI Yezhao

Guangxi Zhuang Autonomous Region National Hospital， Nanning 530001， China

[Abstract] Objective To investigate the value of two-dimensional and color Doppler ultrasound in the diagnosis of urachal fistula. Methods A total of 21 cases of urachal fistul were collected and confirmed by surgery. The clinical data and two-dimensional and color Doppler ultrasound features were retrospectively analyzed. Results The clinical pathological analysis showed that the diagnostic accuracy rate was 86%， and the misdiagnosis rate was 14%. 18 cases of sonographic diagnosis of urachal fistula clearly visible that umbilicus and tubular had no or low echo， fistula with unequal thicknesses， extended to the lower abdomen， lower segment and the bladder was connected. 1 case was misdiagnosed as urachal sinus， 2 cases were misdiagnosed as omphalitis. Conclusion Color Doppler ultrasonography is simple and rapid， safe and efficient， reproducible， and can provide reliable basis for clinical diagnosis of urachal fistula， can be used as the preferred method of imaging of diagnosis urachal fistula.

[Key words] Ultrasonography； Color Doppler ultrasound； Urachal fistula； Diagnosis

臍尿管病变为临床少见疾病，在我国本病约占泌尿系统疾病的1.6%[1]。而脐尿管瘘是脐尿管常见的病变，但在临床上较少见，超声对其特征的分析不多，本文回顾分析21例经临床手术证实的脐尿管瘘患者的资料，旨在进一步探讨二维及彩色多普勒超声对脐尿管瘘的诊断价值，以提高对该病的认识。

1 资料与方法

1.1 临床资料

选择我院2008年1月～2016年6月经二维及彩色多普勒超声诊断脐尿管瘘患者21例，其中男18例，女3例，平均年龄（10.3±0.6）岁，患者多以脐部流液就诊，部分患者伴有脐部红肿压痛。

1.2 仪器与方法

采用Philps HD 15彩超诊断仪，探头频率3.5～7.5 MHz，型号C5-1和L12-5，患者取仰卧位，充分暴露腹部，膀胱适度充盈……