腹壁可聚焦肿物的超声鉴别（二）

Miscellaneous Lesions 其他病变.. Urachal Cyst 胃尿管肾脏A urachal cyst may be seen in between the umbilicus and the bladder. It is usually situated in the lower third of the urachus but can be seen just inferior to the umbilicus. These cysts may appear totally anechoic or may reveal low-level internal echoes (Figure 11 )胃尿管肾脏多见于胃和膀胱之间，多半座落在胃尿管的下1/3 ，但也可多见于均座落在胃下。这些肾脏可表现为完全无回波或更高回波。

Figure 11. A, Urachal cyst. The cyst is infected and contains faintly echogenic fluid. B, Urachal cyst. The anterior wall of the tense cyst produces reverberation artifacts. 所示11A，胃尿管肾脏，此肾脏已受感染，外部含有要强回波的液体。B，胃尿管肾脏，缓和的肾脏前壁产生太阳光伪影。

..Endometriosis子宫子宫病变Endometriosis of the abdominal wall may occur as a long-term complication of uterine surgery. It has no specific appearance but is seen as a focal mass at the scar of previous surgery with attacks of cyclic pain and swelling (Figure 12 ).腰椎子宫子宫病变是子宫出院的仍然合并症，无类似表现，但可于以前动手术的瘢痕一处见一暂时官能肿物，并有周期官能的痉挛和出血。

Figure 12. Endometriosis in a cesarean delivery scar. 所示12 ，剖宫产伤疤一处子宫子宫病变

...Abdominal Wall Hematoma 腰椎血肿A rectus sheath hematoma may develop after paroxysms of coughing or sneezing or after seizures. The underlying cause is usually either anticoagulant therapy or some bleeding disorder. Because these hematomas are limited within the rectus sheath, they are not very big. Their shape depends on their location. Above the arcuate line, they are usually ovoid in shape with the long axis superoinferior and are seen on one side (Figure 13A ). Below the arcuate line, because of the absence of the linea alba, they can extend across the midline. Then the hematoma may be seen as a padlike lesion with its maximum length along the transverse axis.21–23 In one neonate, an abdominal wall hematoma was seen to spread transversely in the supraumbilical region (Figure 13, B and C ). In patients with post surgical disseminated intrascular coagulation, large hematomas are seen in the abdominal wall in the vicinity of the surgical scar (Figure 13D ).疣直肌鞘血肿可发生于发烧官能痉挛后、喷嚏或癫痫发烧后，其深层次多半是抗凝治疗或出血官能疾病。由于血肿放宽于疣直肌鞘内，多半不很大，其形似根据所一处前面而定，在分叉线以上，血肿常为基部，UA呈上下方向，可于正上方看见（所示13A）；在分叉线不限，由于疣白点缺如，可扩展横过中线，因此血肿表现为分齿状，其最大长度座落在横轴上。在产妇腰椎血肿可多见于胃上横向扩展（所示13B、C）。术后星体官能肺部内凝血的病童可于腰椎动手术瘢痕一处看见大的血肿（所示13D）。

Figure 13. A, Rectus sheath hematoma in an elderly woman after severe cough. Arrows point to the fascia transversalis. B, Abdominal wall hematoma in a neonate. C, Abdominal wall hematoma overlying umbilical vein insertion in a neonate. UV indicates umbilical vein. D, Abdominal wall hematoma in a cesarean delivery scar in a patient with disseminated intrascular coagulation. 所示13A，一中年妇女炽热痉挛后疣直肌鞘血肿，对角指示疣横筋膜。B，产妇腰椎血肿。C，一产妇胃静脉覆有一处后面的腰椎血肿。UV，胃静脉。D，一星体官能肺部内凝血的剖宫产术后病童额头一处腰椎血肿。

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