Kolecki R V, Golub R M, Sigel B, Machi J, Kitamura H, Hosokawa T, Justin J, Schwartz J, Zaren H A
Department of Surgery, Medical College of Pennsylvania, Philadelphia 19129.
Surg Endosc. 1994 Aug;8(8):871-4. doi: 10.1007/BF00843457.
Viscera slide is the normal, longitudinal movement of the intraabdominal viscera caused by respiratory excursions of the diaphragm. By detecting areas of restricted viscera slide, ultrasonic imaging was used to identify anterior abdominal wall adhesions prior to laparotomy or laparoscopy. Transcutaneous ultrasound examination was performed on 110 patients. A prediction of adhesions was made for each patient and then compared to the findings during subsequent laparotomy or laparoscopy. Only patients with previous abdominal surgery or history of peritonitis demonstrated adhesions. Sensitivity and specificity of viscera slide ultrasound in predicting adhesions were 90% and 92%. Nine out of 10 false results involved misinterpretation of ultrasound images of the lower one-third of the abdomen. Ultrasonic imaging of viscera slide is highly accurate in detecting abdominal wall adhesions. This technique is most useful in guiding the insertion of trocar in laparoscopic surgery, and as a noninvasive method in studying the formation of adhesions.
脏器滑动是由膈肌的呼吸运动引起的腹腔内脏器正常的纵向移动。通过检测脏器滑动受限区域，超声成像被用于在剖腹手术或腹腔镜检查之前识别前腹壁粘连。对110例患者进行了经皮超声检查。对每位患者进行粘连预测，然后与随后的剖腹手术或腹腔镜检查结果进行比较。只有既往有腹部手术史或腹膜炎病史的患者出现粘连。脏器滑动超声预测粘连的敏感性和特异性分别为90%和92%。10个假结果中有9个涉及对下腹部三分之一超声图像的误判。脏器滑动的超声成像在检测腹壁粘连方面高度准确。该技术在指导腹腔镜手术中套管针的插入以及作为研究粘连形成的非侵入性方法方面最为有用。
