Khamapirad T, Athey P A
J Pediatr. 1983 Jan;102(1):23-6. doi: 10.1016/s0022-3476(83)80280-7.
Thirty infants presenting with vomiting were examined sonographically. In 18 of these patients, a hypoechoic mass medial to the gallbladder and anterior to the right kidney was demonstrated. The mass measured more than 1 cm in diameter in all cases, with an average of 1.7 cm, and was interpreted as representing the hypertrophied muscle mass in pyloric stenosis. Sixteen of these infants had subsequent confirmation of this diagnosis by upper gastrointestinal tract examination and surgery. In two infants, both of whom had a small-diameter mass, the upper gastrointestinal tract study showed an atypical appearing pyloric canal; these two infants were thought to have atypical hypertrophic pyloric stenosis. Of importance technically is operator experience and patience and the use of different patient positions and even real-time imaging for completeness. Potential pitfalls include the fluid-filled duodenal bulb and gastric antrum, which cause a false positive diagnosis, and obscuration of a lesion by overlying bowel gas, which leads to a false negative diagnosis.
对30例出现呕吐症状的婴儿进行了超声检查。在这些患者中，有18例在胆囊内侧和右肾前方显示出低回声肿块。所有病例中肿块直径均超过1厘米，平均为1.7厘米，被解释为代表幽门狭窄的肥厚肌肉团块。其中16例婴儿随后通过上消化道检查和手术确诊。在另外两名婴儿中，肿块直径较小，上消化道研究显示幽门管外观不典型；这两名婴儿被认为患有非典型肥厚性幽门狭窄。从技术角度来看，重要的是操作者的经验和耐心，以及使用不同的患者体位甚至实时成像以确保完整性。潜在的陷阱包括充满液体的十二指肠球部和胃窦，它们会导致假阳性诊断，以及覆盖在病变上方的肠气遮挡病变，从而导致假阴性诊断。
