使用超声波成像评估右上腹肿块:孟加拉国临床评估的综合诊断方法

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摘要

超声波是识别和评估腹部右上象限(RUQ)肿块的重要工具,对于确定肿块涉及的确切器官、组成、特征和向邻近结构的延伸至关重要。这项横断面前瞻性研究在达卡的多家医疗机构进行,利用 3.5MHz 换能器进行实时超声检查,共纳入 130 名患者。在声像图结果异常的 100 名患者中,40% 表现为 RUQ 肿块,主要是男性(75%)。肝脏肿块最常见(75%),包括脓肿、肝细胞癌、继发性病变、血管瘤和单纯囊肿。胆囊肿块(10%)主要包括晚期癌和息肉样肿块。右肾肿块(15%)包括单纯囊肿、严重肾积水、肾细胞癌和血管肌脂肪瘤。超声检查具有诊断准确性高、无创伤、经济实惠和普及性强等特点,是检测右肾肿块的首选初始成像方式。虽然血清学检测、CT 扫描和组织病理学等辅助检查可能是明确诊断所必需的,但超声检查有助于制定初步的患者管理指南。尽管超声波有其局限性,但它在 RUQ 成像中仍然很受欢迎,而且是首选,这也强调了它在临床实践中的重要性。
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Assessment of Masses in the Right Upper Quadrant using Ultrasound Imaging: A Comprehensive Diagnostic Approach for Clinical Evaluation in Bangladesh
Ultrasound serves as a pivotal tool in identifying and assessing masses in the right upper quadrant (RUQ) of the abdomen, crucial for determining precise organ involvement, composition, characteristics, and extension into neighboring structures. This cross-sectional prospective study conducted at various medical facilities in Dhaka enrolled 130 patients, utilizing real-time ultrasound with a 3.5MHz transducer. Among the 100 patients with abnormal sonographic findings, 40% exhibited RUQ masses, predominantly affecting males (75%). Liver masses were most common (75%), including abscesses, hepatocellular carcinomas, secondary lesions, hemangiomas, and simple cysts. Gall bladder masses (10%) mostly consisted of advanced stage carcinomas and polyp-like masses. Right renal masses (15%) comprised simple cysts, severe hydrone-phrosis, renal cell carcinoma, and angiomyolipoma. Ultrasound emerges as the preferred initial imaging modality for RUQ mass detection, offering high diagnostic accuracy, non-invasiveness, affordability, and widespread availability. While supplementary investigations like serological tests, CT scans, and histopathology may be necessary for definitive diagnoses, ultrasound aids in formulating initial patient management guidelines. Despite its limitations, ultrasound remains popular and highly preferred for RUQ imaging, emphasizing its significance in clinical practice.
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