1 All authors: Department of Radiology, Cork University Hospital and University College Cork, Cork, Ireland.
AJR Am J Roentgenol. 2014 Jun;202(6):W506-11. doi: 10.2214/AJR.13.12071.
Educational Objectives and Key Points. 1. Given that abdominal hernias are a frequent imaging finding, radiologists not only are required to interpret the appearances of abdominal hernias but also should be comfortable with identifying associated complications and postrepair findings. 2. CT is the imaging modality of choice for the assessment of a known adult abdominal hernia in both elective and acute circumstances because of rapid acquisition, capability of multiplanar reconstruction, good spatial resolution, and anatomic depiction with excellent sensitivity for most complications. 3. Ultrasound is useful for adult groin assessment and is the imaging modality of choice for pediatric abdominal wall hernia assessment, whereas MRI is beneficial when there is reasonable concern that a patient's symptoms could be attributable to a hernia or a musculoskeletal source. 4. Fluoroscopic herniography is a sensitive radiologic investigation for patients with groin pain in whom a hernia is suspected but in whom a hernia cannot be identified at physical examination. 5. The diagnosis of an internal hernia not only is a challenging clinical diagnosis but also can be difficult to diagnose with imaging: Closed-loop small-bowel obstruction and abnormally located bowel loops relative to normally located small bowel or colon should prompt assessment for an internal hernia.
教学目标和要点。1. 由于腹疝是一种常见的影像学表现，放射科医生不仅需要解释腹疝的表现，还应该能够识别相关的并发症和修复后的发现。2. CT 是评估成人已知腹疝的首选影像学方法，无论是在择期还是急性情况下，因为其采集速度快、能够进行多平面重建、具有良好的空间分辨率以及对大多数并发症具有极好的敏感性，能够很好地显示解剖结构。3. 超声对于成人腹股沟评估有用，是小儿腹壁疝评估的首选影像学方法，而当患者的症状可能归因于疝或肌肉骨骼源时，MRI 则有益。4. 疝造影术对于怀疑有疝但体格检查无法发现疝的腹股沟疼痛患者是一种敏感的放射学检查方法。5. 内疝的诊断不仅是一个具有挑战性的临床诊断，而且用影像学诊断也很困难：闭襻性小肠梗阻和相对于正常位置的小肠或结肠的异常位置的肠袢应提示评估内疝。
