Zhang G Q, Sugiyama M, Hagi H, Urata T, Shimamori N, Atomi Y
First Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.
J Clin Ultrasound. 2001 Oct;29(8):429-34. doi: 10.1002/jcu.10000.
We assessed the abilities of color Doppler and power Doppler sonography to distinguish among types of groin hernias by demonstrating the inferior epigastric artery (IEA) and its relationship with the hernia sac.
Nineteen consecutive patients (14 men and 5 women), clinically diagnosed as having groin hernias and scheduled to undergo herniorrhaphy, were prospectively enrolled in this study. Ultrasound examinations were performed preoperatively with a 6-12-MHz linear-array transducer. The IEA was identified, if possible, and its relationship to the hernia sac assessed. The sonographic diagnoses were compared with the operative findings.
There were 15 indirect inguinal hernias, 4 direct inguinal hernias, and 1 femoral hernia; 1 patient had bilateral inguinal hernias (indirect and direct). In 18 (90%) of 20 hernia cases, the trunk segment of the IEA could be visualized. In 11 (55%) of 20 hernia cases, the origin segment of the IEA could be visualized and its relationship with the hernia sac assessed. In 9 (82%) of the 11 hernia cases, hernia types were correctly diagnosed by sonography. The overall accuracy of sonography for diagnosing the type of hernia was 45% (9 of 20 hernias).
Color Doppler sonography can accurately differentiate types of groin hernias if the origin segment of the IEA and the hernia sac can be visualized simultaneously. However, color Doppler sonography sometimes failed to visualize this segment.
我们通过显示腹壁下动脉（IEA）及其与疝囊的关系，评估彩色多普勒超声和能量多普勒超声区分腹股沟疝类型的能力。
19例连续患者（14例男性和5例女性），临床诊断为腹股沟疝且计划接受疝修补术，前瞻性纳入本研究。术前使用6-12MHz线阵探头进行超声检查。尽可能识别IEA，并评估其与疝囊的关系。将超声诊断结果与手术发现进行比较。
有15例腹股沟斜疝、4例腹股沟直疝和1例股疝；1例患者有双侧腹股沟疝（斜疝和直疝）。在20例疝病例中的18例（90%），可以看到IEA的主干段。在20例疝病例中的11例（55%），可以看到IEA的起始段，并评估其与疝囊的关系。在11例疝病例中的9例（82%），通过超声正确诊断了疝的类型。超声诊断疝类型的总体准确率为45%（20例疝中的9例）。
如果能同时看到IEA的起始段和疝囊，彩色多普勒超声可以准确区分腹股沟疝的类型。然而，彩色多普勒超声有时无法看到该段。
