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contrast-enhanced ultrasound using SonoVue mixed with oral gastrointestinal contrast agent to evaluate esophageal hiatal hernia: Report of three cases and a literature review

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World Journal of Clinical Cases 2021年第11期9卷 2679-2687页

作者： Jing-Yu Wang Yan Luo Wen-Ying Wang Shi-Cheng Zheng Lian He Chun-Yan Xie Li Peng Department of Ultrasound First People's Hospital of Longquanyi DistrictLongquan Hospital of West China Hospital of Sichuan UniversityChengdu 610100Sichuan ProvinceChina Department of Ultrasound West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Gastroenterology First People's Hospital of Longquanyi DistrictLongquan Hospital of West China Hospital of Sichuan UniversityChengdu 610100Sichuan ProvinceChina

BACKGROUND Due to a thicker abdominal wall in some patients,ultrasound artifacts from gastrointestinal gas and surrounding tissues can interfere with routine ultrasound examination,precluding its ability to display or clearly show the structure of a hernial sac(HS)and thereby diminishing diagnostic performance for esophageal hiatal hernia(EHH).contrast-enhanced ultrasound(CEUS)imaging using an oral agent mixture allows for clear and intuitive identification of an EHH sac and dynamic observation of esophageal *** SUMMARY In this case series,we report three patients with clinically-suspected EHH,including two females and one male with an average age of 67.3±16.4 *** was administered with an oral agent mixture(microbubble-based SonoVue and gastrointestinal contrast agent)and identified a direct sign of supradiaphragmatic HS(containing the hyperechoic agent)and indirect signs[e.g.,widening of esophageal hiatus,hyperechoic mixture agent continuously or intermittently reflux flowing back and forth from the stomach into the supradiaphragmatic HS,and esophagus-gastric echo ring(i.e.,the“EG”ring)seen above the diaphragm].All three cases received a definitive diagnosis of EHH by esophageal manometry and *** lesions resolved upon drug treatment and one required *** recurrence rate in follow-up was 0%.The data from these cases suggest that the new non-invasive examination method may greatly improve the diagnosis of *** CEUS with the oral agent mixture can facilitate clear and intuitive identification of HS and dynamic observation of esophageal reflux.

关键词： SonoVue oral gastrointestinal contrast agent contrast-enhanced ultrasound gastrointestinal Hiatal hernia Case report

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