Worlicek H
Medizinische Klinik mit Poliklinik, Universität Erlangen-Nürnberg.
Bildgebung. 1987;56(1):27-34.
With the aid of a subtle examination technique using suitable ultrasonic equipment, it is possible to visualize small and large bowel wall changes. In a prospective study, 416 patients with small-bowel or large-bowel diseases, and 197 patients with no diseases affecting the intestinal tract were investigated. It was found that the wall thickness--as reflected in the thickness of the echo-poor outer ring - in the healthy bowel may measure up to 3 mm. A thickness of 4-5 mm must be considered borderline. A wall thickness of 6 mm or more is one of a number of morphological changes that signal intestinal disease. In 78.4% of the cases, the pathological finding was correctly described or correctly evaluated with respect to its biological significance with the aid of ultrasound. An accurate determination of the anatomical localization was possible in 92.3% of these cases. The ultrasonographic appearance of the various bowel diseases is not infrequently similar or even identical. Nevertheless, the detection of a pathological finding always makes it possible to narrow down the differential diagnosis. Ultrasonography is a suitable procedure for the detection and follow-up of intestinal wall thickening, which represents an important patho-morphological substrate of a number of intestinal diseases. Within the framework of small and large bowel diagnostic evaluation, it should be used alongside endoscopy and X-ray contrast examination. Ultrasound is not able to exclude possible bowel disease.
借助使用合适超声设备的精细检查技术，可以观察到小肠和大肠壁的变化。在一项前瞻性研究中，对416例患有小肠或大肠疾病的患者以及197例无肠道疾病的患者进行了调查。结果发现，健康肠道中壁厚度（以低回声外环厚度表示）可达3毫米。4至5毫米的厚度必须视为临界值。6毫米或更厚的壁厚度是提示肠道疾病的多种形态学变化之一。在78.4%的病例中，借助超声对病理发现进行了正确描述或对其生物学意义进行了正确评估。在92.3%的这些病例中能够准确确定解剖定位。各种肠道疾病的超声表现常常相似甚至相同。然而，病理发现的检测总能缩小鉴别诊断范围。超声检查是检测和随访肠壁增厚的合适方法，肠壁增厚是多种肠道疾病的重要病理形态学基础。在小肠和大肠诊断评估框架内，应与内镜检查和X线造影检查一起使用。超声不能排除可能的肠道疾病。
