Department of Radiology, Phoenix Children's Hospital, 1919 E. Thomas Road, Phoenix, AZ, 85016, USA.
Department of Child Health and Radiology, University of Arizona College of Medicine, Phoenix, AZ, USA.
Pediatr Radiol. 2022 Apr;52(4):716-722. doi: 10.1007/s00247-021-05154-0. Epub 2021 Oct 11.
Upper gastrointestinal series is considered the gold standard imaging test to evaluate for malrotation and midgut volvulus. US has been explored for this purpose in recent years and has been shown to be a good alternative because of its relatively good accuracy, fast learning curve for sonographers and radiologists, as well as convenience for children, clinical staff and radiologists in the neonatal intensive care unit. In this article we describe our experience and review the evidence supporting the use of emergency US primarily to diagnose midgut volvulus as well as its use as a problem-solving tool for the diagnosis of malrotation. The examination technique, normal and abnormal findings are described, with emphasis on the whirlpool and superior mesenteric artery cutoff signs to diagnose midgut volvulus.
上消化道造影被认为是评估肠旋转不良和中肠扭转的金标准影像学检查。近年来,超声检查也被用于该目的,由于其具有相对较高的准确性、超声医师和放射科医师易于学习、以及对新生儿重症监护病房的患儿、临床医护人员和放射科医师均较为方便的特点,因此已被证明是一种很好的替代方法。本文将介绍我们的经验,并复习支持使用急诊超声主要诊断中肠扭转以及将其作为诊断肠旋转不良的一种解决问题的工具的证据。本文描述了检查技术、正常和异常发现,重点介绍了漩涡和肠系膜上动脉截断征来诊断中肠扭转。