Zhang Wenzhi, Yu Xiulei, Li Jun, Wang Lingling, Chu Jie
Department of Ultrasonography, Hangzhou Red Cross Hospital (Integrated Chinese and Western Hospital of Zhejiang Province), No. 208 Huancheng East Road, Hangzhou, Zhejiang, 310003, P.R. China.
BMC Infect Dis. 2024 Dec 18;24(1):1410. doi: 10.1186/s12879-024-10318-y.
To evaluate the diagnostic value of contrast-enhanced ultrasound (CEUS) in detecting tuberculous diaphragmatic abscess (TDA) of the right diaphragm and provide a reference for its clinical diagnosis.
A retrospective analysis was conducted on 33 patients with right TDA confirmed via surgery and biopsy. The diagnostic accuracy of CEUS and routine ultrasound for detecting right TDA was compared.
Among the 33 right TDA cases, the lesions primarily exhibited mixed and low echogenicity, with an orientation parallel to the diaphragmatic surface. Eighteen patients (54.5%) demonstrated the characteristic "crocodile mouth sign." Heterogeneous enhancement was observed in most cases (24 patients) compared to homogeneous or no enhancement. The diagnostic accuracy of routine ultrasound for right TDA was 54.50% (18/33), whereas CEUS demonstrated a significantly higher accuracy of 78.78% (26/33) (χ = 4.364, P = 0.037).
CEUS provides valuable insights into the vascular characteristics of right TDA, with most cases showing mixed echogenicity and heterogeneous enhancement. The "crocodile mouth sign" was a distinctive feature, highlighting the utility of CEUS in improving diagnostic accuracy for right TDA.
评估超声造影（CEUS）在检测右侧膈下结核性脓肿（TDA）中的诊断价值，为其临床诊断提供参考。
对33例经手术及活检确诊为右侧TDA的患者进行回顾性分析。比较CEUS和常规超声检测右侧TDA的诊断准确性。
在33例右侧TDA病例中，病变主要表现为混合性和低回声，与膈面平行。18例患者（54.5%）表现出特征性的“鳄鱼嘴征”。与均匀增强或无增强相比，大多数病例（24例）观察到不均匀增强。常规超声对右侧TDA的诊断准确性为54.50%（18/33），而CEUS的准确性显著更高，为78.78%（26/33）（χ = 4.364，P = 0.037）。
CEUS为右侧TDA的血管特征提供了有价值的见解，大多数病例表现为混合回声和不均匀增强。“鳄鱼嘴征”是一个独特的特征，突出了CEUS在提高右侧TDA诊断准确性方面的效用。
