腹部超音波

腹部超音波檢查
腹部超音波檢查
	腹部超音波檢查所用的超音波掃描儀
ICD-9-CM	88.76
OPS-301（英語：OPS-301）	3-059
MedlinePlus	003777

腹部超音波是一種醫學超音波檢查，用於檢查人體腹部。在病人腹部塗上超音波導電凝膠後，超音波探頭發出的聲波就能穿透腹部表面的腹壁（英語：Abdominal wall），到達各器官。超音波探頭將從器官反射的超音波收集分析後，便能產出腹部影像。因此，這項檢查也被稱為跨腹超音波，與直接將探頭以內窺鏡方式放入人體中空器官的內鏡超音波（英語：Endoscopic ultrasound）有所不同。

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腹部超音波檢查通常由腸胃科、內科或放射科醫生進行，亦可由超音波技師（英語：Sonographer）進行。

用途

腹部超音波可用於判斷不同體內器官的異常，例如腎臟^[1]、肝臟、膽囊、胰臟、脾臟、腹主動脈（英語：Abdominal aorta）等。如果超音波儀器有都卜勒超音波（英語：Doppler ultrasonography）功能，還可以檢查血管中的血液流動狀況，協助診斷腎動脈狹窄等疾病。此外，腹部超音波亦常用於檢查懷孕婦女的子宮與胎兒；這類檢查稱為產科超音波（英語：Obstetric ultrasonography）^[2]^[3]。

當病患出現腹痛或急性腹痛（英語：Acute abdomen），腹部超音波可用於診斷病者是否患上闌尾炎及膽囊炎，以便安排緊急手術^[4]^[5]。

當醫生懷疑腹部器官可能異常脹大時，也會進行腹部超音波檢查。能發現的病症包括腹主動脈瘤、脾臟腫大（英語：Splenomegaly）、尿瀦留等。診斷為腹主動脈瘤的標準是：腹主動脈（以最外層計算）的直徑超過3厘米，即為腹主動脈瘤^[6]。

脾臟腫大是傳染性單核白血球增多症的常見徵狀。腹部超音波可以協助檢查患上此症者的狀況^[7]，但由於正常人體脾臟的大小差異很大，超音波只應用於協助診斷脾臟腫大，而不應作為診斷的唯一依據，也不應僅依據超音波結果來決定病者是否適合恢復運動^[7]。

腹部超音波也用於檢查腎臟功能（英語：Assessment of kidney function）異常、胰臟消化酶（如澱粉酶、胰臟脂酶（英語：Pancreatic lipase family））功能異常的病人。

結石檢查

超音波能發現體內的結石，包括腎石、膽結石等。由於結石會吸收超音波，影像上將看到結石的後方出現黑色陰影（英語：Acoustic shadow）。^[8]

超音波亦可用於導引不同治療程序，如導引體外震波、針刺活檢及腹部穿刺引流（英語：Paracentesis）（通過針刺從腹腔中抽走積水的治療）等等^[9]。

肝臟

腹部超音波有助診斷肝功能指數異常的原因。超音波圖像中可以看到的異常包括肝腫大^[11]、反射增強（可能由膽汁鬱積（英語：cholestasis）所致）^[12]、膽囊或膽管病症、肝臟腫瘤等^[13]。

腎臟超音波

腎臟超音波是診斷與跟進腎臟疾病的重要常用工具。腎臟超音波的圖像清晰，而且大部分腎臟病變都能在超音波圖像中識別出來。^[14]

技術特點

腹部超音波的優點包括：方便快捷、可直接在病床邊進行檢查、不需使用對人體（特別是孕婦）有危害的X光、相比其他腹部造影檢查（如電腦掃描）便宜等等^[15]。但一個主要缺點則是，如果病人腸道內有大量氣體，或腹部脂肪較多，將難以進行檢查，影像的品質也不好^[16]。此外，檢查中能否獲取滿意的超音波影像，相當依賴進行檢查的醫護人員的經驗與技術水平^[17]。

腹部超音波的影像在檢查時就可以即時看到^[18]，進行檢查時也不須麻醉，所以可以通過移動探頭來檢查病人的反應^[19]。例如，將探頭按在病人的膽囊上，如果病人感到痛楚（英語：Sonographic Murphy sign），即可能是患上急性膽囊炎^[20]。

超音波能夠穿透腹壁，檢查骨盆內的器官與組織，例如膀胱、卵巢、子宮等。水是超音波極佳的傳導媒介，所以檢查這些器官前，會請病人大量喝水，讓膀胱盡量脹大，以便超音波訊號穿透^[21]^[22]。

參考資料

[1]
Bisset. Differential Diagnosis in Abdominal Ultrasound, 3/e. Elsevier India. 2008-01-01: 257 [2011-04-10]. ISBN 978-81-312-1574-6.
[2]
Whitworth, M; Bricker, L; Mullan, C. Ultrasound for fetal assessment in early pregnancy. Cochrane Database of Systematic Reviews. 2015, (7): CD007058. PMC 4084925 . PMID 26171896. doi:10.1002/14651858.CD007058.pub3.
[3]
Salomon, LJ; Alfirevic, Z; Bilardo, CM; Chalouhi, GE; Ghi, T; Kagan, KO; Lau, TK; Papageorghiou, AT; Raine-Fenning, NJ; Stirnemann, J; Suresh, S; Tabor, A; Timor-Tritsch, IE; Toi, A; Yeo, G. ISUOG Practice Guidelines: performance of first-trimester fetal ultrasound scan (PDF). Ultrasound Obstet Gynecol. 2013, 41: 102–113 [2015-05-12]. PMID 23280739. doi:10.1002/uog.12342 . （原始內容 (PDF)存檔於2015-09-06）.
[4]
Puylaert, Julien B.C.M.; Rutgers, Peter H.; Lalisang, Roy I.; de Vries, Bas C.; van der Werf, Sjoerd D.J.; Dörr, Joep P.J.; Blok, Roeland A.P.R. A Prospective Study of Ultrasonography in the Diagnosis of Appendicitis. New England Journal of Medicine. 1987-09-10, 317 (11): 666–669. ISSN 0028-4793. PMID 3306375. doi:10.1056/NEJM198709103171103.
[5]
Ultrasonography by emergency physicians in patients with suspected cholecystitis. The American Journal of Emergency Medicine. 2001-01-01, 19 (1): 32–36 [2021-09-13]. ISSN 0735-6757. doi:10.1053/ajem.2001.20028. （原始內容存檔於2021-09-13）（英語）.
[6]
Timothy Jang. Bedside Ultrasonography Evaluation of Abdominal Aortic Aneurysm - Technique. Medscape（英語：Medscape）. 2017-08-28.
[7]
American Medical Society for Sports Medicine, Five Things Physicians and Patients Should Question, Choosing Wisely（英語：Choosing Wisely）: an initiative of the ABIM Foundation（英語：American Board of Internal Medicine） (American Medical Society for Sports Medicine), 24 April 2014 [29 July 2014], （原始內容存檔於2014-07-29）, which cites
- Putukian, M; O'Connor, FG; Stricker, P; McGrew, C; Hosey, RG; Gordon, SM; Kinderknecht, J; Kriss, V; Landry, G. Mononucleosis and athletic participation: an evidence-based subject review. Clinical Journal of Sport Medicine. 2008-07, 18 (4): 309–15. PMID 18614881. doi:10.1097/JSM.0b013e31817e34f8.
- Spielmann, AL; DeLong, DM; Kliewer, MA. Sonographic evaluation of spleen size in tall healthy athletes.. AJR. American Journal of Roentgenology. 2005-01, 184 (1): 45–9. PMID 15615949. doi:10.2214/ajr.184.1.01840045.
[8]
Dunmire, Barbrina; Harper, Jonathan D.; Cunitz, Bryan W.; Lee, Franklin C.; Hsi, Ryan; Liu, Ziyue; Bailey, Michael R.; Sorensen, Mathew D. Use of the Acoustic Shadow Width to Determine Kidney Stone Size with Ultrasound. Journal of Urology. 2016-01, 195 (1): 171–177 [2021-09-12]. doi:10.1016/j.juro.2015.05.111.
[9]
Dogra, Vikram.; Saad, Wael E. A. Ultrasound-guided procedures. New York, NY: Thieme. 2010. ISBN 9781604061703.
[10]
Christoph F. Dietrich; Carla Serra; Maciej Jedrzejczyk. Ultrasound of the liver - EFSUMB – European Course Book (PDF). European federation of societies for ultrasound in medicine and biology (EFSUMB). 2010-07-28 [2017-12-22]. （原始內容 (PDF)存檔於2017-08-12）.
[11]
Childs, Jessie T; Esterman, Adrian J; Thoirs, Kerry A; Turner, Richard C. Ultrasound in the assessment of hepatomegaly: A simple technique to determine an enlarged liver using reliable and valid measurements: Ultrasound in the assessment of hepatomegaly. Sonography. 2016-06, 3 (2): 47–52 [2021-09-13]. doi:10.1002/sono.12051. （原始內容存檔於2021-09-13）.
[12]
Di Serafino, Marco; Gioioso, Matilde; Severino, Rosa; Esposito, Francesco; Vezzali, Norberto; Ferro, Federica; Pelliccia, Piernicola; Caprio, Maria Grazia; Iorio, Raffaele; Vallone, Gianfranco. Ultrasound findings in paediatric cholestasis: how to image the patient and what to look for. Journal of Ultrasound. 2020-03, 23 (1): 1–12 [2021-09-13]. doi:10.1007/s40477-019-00362-9. （原始內容存檔於2022-03-14）.
[13]
Janice Hickey, Franklin Goldberg. Ultrasound review of the abdomen, male pelvis & small parts. Philadelphia : Lippincott. 1999. ISBN 0397516916.
[14]
內容來自： Hansen, Kristoffer; Nielsen, Michael; Ewertsen, Caroline. Ultrasonography of the Kidney: A Pictorial Review. Diagnostics. 2015, 6 (1): 2. ISSN 2075-4418. PMC 4808817 . PMID 26838799. doi:10.3390/diagnostics6010002. (CC-BY 4.0) （頁面存檔備份，存於互聯網檔案館）
[15]
Noone, Tara C.; Semelka, Richard C.; Chaney, Deneise M.; Reinhold, Caroline. Abdominal imaging studies: comparison of diagnostic accuracies resulting from ultrasound, computed tomography, and magnetic resonance imaging in the same individual. Magnetic Resonance Imaging. 2004-01, 22 (1): 19–24 [2021-09-12]. doi:10.1016/j.mri.2003.01.001. （原始內容存檔於2021-09-12）.
[16]
Berthold Block. Abdominal Ultrasound: Step by Step 2nd edition. Georg Thieme Verlag, Stuttgart, Germany: Thieme. 2012 [2021-09-12]. ISBN 9783131383631. （原始內容存檔於2022-08-07）.
[17]
Miele, Vittorio; Piccolo, Claudia Lucia; Galluzzo, Michele; Ianniello, Stefania; Sessa, Barbara; Trinci, Margherita. Contrast-enhanced ultrasound (CEUS) in blunt abdominal trauma. The British Journal of Radiology. 2016-05, 89 (1061): 20150823 [2021-09-12]. doi:10.1259/bjr.20150823. （原始內容存檔於2021-09-12）.
[18]
García de Casasola Sánchez, G.; Torres Macho, J.; Casas Rojo, J.M.; Cubo Romano, P.; Antón Santos, J.M.; Villena Garrido, V.; Diez Lobato, R. Abdominal Ultrasound and Medical Education. Revista Clínica Española (English Edition). 2014-04, 214 (3): 131–136 [2021-09-12]. doi:10.1016/j.rceng.2013.11.001. （原始內容存檔於2021-09-12）.
[19]
Access to Assistive Technology and Medical Devices, Access to Medicines and Health Products, Health Product Policy and Standards, Medical Devices and Diagnostics. Elisabetta Buscarini, Harald Lutz and Paoletta Mirk , 編. Manual of diagnostic ultrasound 2nd ed. World Health Organization. 2013 [2021-09-12]. ISBN 9789241548540. （原始內容存檔於2022-03-20）.
[20]
Simeone, Jf; Brink, Ja; Mueller, Pr; Compton, C; Hahn, Pf; Saini, S; Silverman, Sg; Tung, G; Ferrucci, Jt. The sonographic diagnosis of acute gangrenous cholecystitis: importance of the Murphy sign. American Journal of Roentgenology. 1989-02, 152 (2): 289–290 [2021-09-12]. PMID 2643262. doi:10.2214/ajr.152.2.289. （原始內容存檔於2022-08-10）.
[21]
Benacerraf, B R; Shipp, T D; Bromley, B. Is a full bladder still necessary for pelvic sonography?. Journal of Ultrasound in Medicine. 2000-04, 19 (4): 237–241 [2021-09-12]. doi:10.7863/jum.2000.19.4.237. （原始內容存檔於2021-09-12）.
[22]
NHS. Ultrasound scan. nhs.uk. 2017-10-18 [2021-09-12]. （原始內容存檔於2022-10-19）（英語）.

[Bisset2008-1] [1]
Bisset. Differential Diagnosis in Abdominal Ultrasound, 3/e. Elsevier India. 2008-01-01: 257 [2011-04-10]. ISBN 978-81-312-1574-6.

[2] [2]
Whitworth, M; Bricker, L; Mullan, C. Ultrasound for fetal assessment in early pregnancy. Cochrane Database of Systematic Reviews. 2015, (7): CD007058. PMC 4084925 . PMID 26171896. doi:10.1002/14651858.CD007058.pub3.

[3] [3]
Salomon, LJ; Alfirevic, Z; Bilardo, CM; Chalouhi, GE; Ghi, T; Kagan, KO; Lau, TK; Papageorghiou, AT; Raine-Fenning, NJ; Stirnemann, J; Suresh, S; Tabor, A; Timor-Tritsch, IE; Toi, A; Yeo, G. ISUOG Practice Guidelines: performance of first-trimester fetal ultrasound scan (PDF). Ultrasound Obstet Gynecol. 2013, 41: 102–113 [2015-05-12]. PMID 23280739. doi:10.1002/uog.12342 . （原始內容 (PDF)存檔於2015-09-06）.

[4] [4]
Puylaert, Julien B.C.M.; Rutgers, Peter H.; Lalisang, Roy I.; de Vries, Bas C.; van der Werf, Sjoerd D.J.; Dörr, Joep P.J.; Blok, Roeland A.P.R. A Prospective Study of Ultrasonography in the Diagnosis of Appendicitis. New England Journal of Medicine. 1987-09-10, 317 (11): 666–669. ISSN 0028-4793. PMID 3306375. doi:10.1056/NEJM198709103171103.

[5] [5]
Ultrasonography by emergency physicians in patients with suspected cholecystitis. The American Journal of Emergency Medicine. 2001-01-01, 19 (1): 32–36 [2021-09-13]. ISSN 0735-6757. doi:10.1053/ajem.2001.20028. （原始內容存檔於2021-09-13）（英語）.

[medscape-6] [6]
Timothy Jang. Bedside Ultrasonography Evaluation of Abdominal Aortic Aneurysm - Technique. Medscape（英語：Medscape）. 2017-08-28.

[AMSSMfive-7] [7]
American Medical Society for Sports Medicine, Five Things Physicians and Patients Should Question, Choosing Wisely（英語：Choosing Wisely）: an initiative of the ABIM Foundation（英語：American Board of Internal Medicine） (American Medical Society for Sports Medicine), 24 April 2014 [29 July 2014], （原始內容存檔於2014-07-29）, which cites
Putukian, M; O'Connor, FG; Stricker, P; McGrew, C; Hosey, RG; Gordon, SM; Kinderknecht, J; Kriss, V; Landry, G. Mononucleosis and athletic participation: an evidence-based subject review. Clinical Journal of Sport Medicine. 2008-07, 18 (4): 309–15. PMID 18614881. doi:10.1097/JSM.0b013e31817e34f8.

Spielmann, AL; DeLong, DM; Kliewer, MA. Sonographic evaluation of spleen size in tall healthy athletes.. AJR. American Journal of Roentgenology. 2005-01, 184 (1): 45–9. PMID 15615949. doi:10.2214/ajr.184.1.01840045.

[8] Putukian, M; O'Connor, FG; Stricker, P; McGrew, C; Hosey, RG; Gordon, SM; Kinderknecht, J; Kriss, V; Landry, G. Mononucleosis and athletic participation: an evidence-based subject review. Clinical Journal of Sport Medicine. 2008-07, 18 (4): 309–15. PMID 18614881. doi:10.1097/JSM.0b013e31817e34f8.

[9] Spielmann, AL; DeLong, DM; Kliewer, MA. Sonographic evaluation of spleen size in tall healthy athletes.. AJR. American Journal of Roentgenology. 2005-01, 184 (1): 45–9. PMID 15615949. doi:10.2214/ajr.184.1.01840045.

[8] [8]
Dunmire, Barbrina; Harper, Jonathan D.; Cunitz, Bryan W.; Lee, Franklin C.; Hsi, Ryan; Liu, Ziyue; Bailey, Michael R.; Sorensen, Mathew D. Use of the Acoustic Shadow Width to Determine Kidney Stone Size with Ultrasound. Journal of Urology. 2016-01, 195 (1): 171–177 [2021-09-12]. doi:10.1016/j.juro.2015.05.111.

[9] [9]
Dogra, Vikram.; Saad, Wael E. A. Ultrasound-guided procedures. New York, NY: Thieme. 2010. ISBN 9781604061703.

[efsumb2010-10] [10]
Christoph F. Dietrich; Carla Serra; Maciej Jedrzejczyk. Ultrasound of the liver - EFSUMB – European Course Book (PDF). European federation of societies for ultrasound in medicine and biology (EFSUMB). 2010-07-28 [2017-12-22]. （原始內容 (PDF)存檔於2017-08-12）.

[11] [11]
Childs, Jessie T; Esterman, Adrian J; Thoirs, Kerry A; Turner, Richard C. Ultrasound in the assessment of hepatomegaly: A simple technique to determine an enlarged liver using reliable and valid measurements: Ultrasound in the assessment of hepatomegaly. Sonography. 2016-06, 3 (2): 47–52 [2021-09-13]. doi:10.1002/sono.12051. （原始內容存檔於2021-09-13）.

[12] [12]
Di Serafino, Marco; Gioioso, Matilde; Severino, Rosa; Esposito, Francesco; Vezzali, Norberto; Ferro, Federica; Pelliccia, Piernicola; Caprio, Maria Grazia; Iorio, Raffaele; Vallone, Gianfranco. Ultrasound findings in paediatric cholestasis: how to image the patient and what to look for. Journal of Ultrasound. 2020-03, 23 (1): 1–12 [2021-09-13]. doi:10.1007/s40477-019-00362-9. （原始內容存檔於2022-03-14）.

[13] [13]
Janice Hickey, Franklin Goldberg. Ultrasound review of the abdomen, male pelvis & small parts. Philadelphia : Lippincott. 1999. ISBN 0397516916.

[Hansen2015-14] [14]
內容來自： Hansen, Kristoffer; Nielsen, Michael; Ewertsen, Caroline. Ultrasonography of the Kidney: A Pictorial Review. Diagnostics. 2015, 6 (1): 2. ISSN 2075-4418. PMC 4808817 . PMID 26838799. doi:10.3390/diagnostics6010002. (CC-BY 4.0) （頁面存檔備份，存於互聯網檔案館）

[15] [15]
Noone, Tara C.; Semelka, Richard C.; Chaney, Deneise M.; Reinhold, Caroline. Abdominal imaging studies: comparison of diagnostic accuracies resulting from ultrasound, computed tomography, and magnetic resonance imaging in the same individual. Magnetic Resonance Imaging. 2004-01, 22 (1): 19–24 [2021-09-12]. doi:10.1016/j.mri.2003.01.001. （原始內容存檔於2021-09-12）.

[16] [16]
Berthold Block. Abdominal Ultrasound: Step by Step 2nd edition. Georg Thieme Verlag, Stuttgart, Germany: Thieme. 2012 [2021-09-12]. ISBN 9783131383631. （原始內容存檔於2022-08-07）.

[17] [17]
Miele, Vittorio; Piccolo, Claudia Lucia; Galluzzo, Michele; Ianniello, Stefania; Sessa, Barbara; Trinci, Margherita. Contrast-enhanced ultrasound (CEUS) in blunt abdominal trauma. The British Journal of Radiology. 2016-05, 89 (1061): 20150823 [2021-09-12]. doi:10.1259/bjr.20150823. （原始內容存檔於2021-09-12）.

[18] [18]
García de Casasola Sánchez, G.; Torres Macho, J.; Casas Rojo, J.M.; Cubo Romano, P.; Antón Santos, J.M.; Villena Garrido, V.; Diez Lobato, R. Abdominal Ultrasound and Medical Education. Revista Clínica Española (English Edition). 2014-04, 214 (3): 131–136 [2021-09-12]. doi:10.1016/j.rceng.2013.11.001. （原始內容存檔於2021-09-12）.

[19] [19]
Access to Assistive Technology and Medical Devices, Access to Medicines and Health Products, Health Product Policy and Standards, Medical Devices and Diagnostics. Elisabetta Buscarini, Harald Lutz and Paoletta Mirk , 編. Manual of diagnostic ultrasound 2nd ed. World Health Organization. 2013 [2021-09-12]. ISBN 9789241548540. （原始內容存檔於2022-03-20）.

[20] [20]
Simeone, Jf; Brink, Ja; Mueller, Pr; Compton, C; Hahn, Pf; Saini, S; Silverman, Sg; Tung, G; Ferrucci, Jt. The sonographic diagnosis of acute gangrenous cholecystitis: importance of the Murphy sign. American Journal of Roentgenology. 1989-02, 152 (2): 289–290 [2021-09-12]. PMID 2643262. doi:10.2214/ajr.152.2.289. （原始內容存檔於2022-08-10）.

[21] [21]
Benacerraf, B R; Shipp, T D; Bromley, B. Is a full bladder still necessary for pelvic sonography?. Journal of Ultrasound in Medicine. 2000-04, 19 (4): 237–241 [2021-09-12]. doi:10.7863/jum.2000.19.4.237. （原始內容存檔於2021-09-12）.

[22] [22]
NHS. Ultrasound scan. nhs.uk. 2017-10-18 [2021-09-12]. （原始內容存檔於2022-10-19）（英語）.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

[20]

[21]

[22]