CAJ | 학술논문

目的：探讨正常直肠腔内灌注超声造影和静脉超声造影表现。方法排除直肠病变和直肠息肉的患者26例，应用经直肠腔内灌注超声造影观察正常直肠壁层次结构，然后静脉注射微泡造影剂，观察直肠壁的血流灌注，分析肠壁各层结构的增强情况。结果直肠腔内灌注超声造影显示直肠壁为高低回声相间的7层结构，由内到外分别为：造影剂与黏膜表层形成回声界面的高回声层，黏膜的低回声层，黏膜下层的高回声层，环肌层的低回声层，肌层间纤维结缔组织层的高回声层，纵肌层的低回声层，外膜层的高回声层。静脉超声造影显示直肠壁为高低增强相间的3层结构，黏膜层与黏膜下层的高增强，固有肌层的低增强，外膜层的高增强。结论正常直肠壁在腔内灌注超声造影中呈现7层结构；静脉超声造影显示固有肌层血流低灌注，其余层次高灌注。
목적：탐토정상직장강내관주초성조영화정맥초성조영표현。방법배제직장병변화직장식육적환자26례，응용경직장강내관주초성조영관찰정상직장벽층차결구，연후정맥주사미포조영제，관찰직장벽적혈류관주，분석장벽각층결구적증강정황。결과직장강내관주초성조영현시직장벽위고저회성상간적7층결구，유내도외분별위：조영제여점막표층형성회성계면적고회성층，점막적저회성층，점막하층적고회성층，배기층적저회성층，기층간섬유결체조직층적고회성층，종기층적저회성층，외막층적고회성층。정맥초성조영현시직장벽위고저증강상간적3층결구，점막층여점막하층적고증강，고유기층적저증강，외막층적고증강。결론정상직장벽재강내관주초성조영중정현7층결구；정맥초성조영현시고유기층혈류저관주，기여층차고관주。
Objective To investigate the hierarchical structure of normal rectal walls using intrarectal and intravenous contrast-enhanced unltrasonography (double contrast-enhanced ultrasonography,DCUS). Methods Twenty-six patients with porctopolypus or normal rectum were enrolled in this study and DCUS were used. The layers and blood perfusion characteristic of the rectum were observed by DCUS. Results The intrarectal contrast-enhanced unltrasonography showed normal rectal walls had seven layers with the alternation of hyper and hypo echos. From inner to outer, they were hyperechoic acoustic interface, hypoechoic mucosa, hyperechoic submucosa, hypoechoic circular muscle, hyperechoic tela conjunctiva, hypoechoic longitudinal muscle and hyperechoic serosa, respectively. The intravenous contrast-enhanced ultrasonography showed that normal rectal walls had three layers with the alternation of hyper and hypo enhancements. mucosa and submucosa were hyperenhanced, muscularis propria was hypoenhanced and serosa was hyperenhanced. Conclusion There are 7 layers in normal rectal wall using intrarectal contrast-enhanced ultrasonography. Intravenous contrast-enhanced ultrasonography shows muscularis propria is hypoenhanced, while other layers are hyperenhanced.