腹壁可触及肿物的超音波鉴别（二）

Miscellaneous Lesions 其他病变.. Urachal Cyst 脐尿管肾脏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 )脐尿管肾脏载于脐和膀胱之间，不一定位处脐尿管的下1/3 ，但也可载于极少位处脐下。这些肾脏可体现为完全无回波或较高回波。

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. 布11A，脐尿管肾脏，此肾脏已受病毒，之下带有要强回波的容器。B，脐尿管肾脏，紧迫的肾脏前壁消除反射伪影。

..Endometriosis内膜肾脏甲状腺肿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 ).腰椎内膜肾脏甲状腺肿是内膜开刀后的长期合并症，无独有体现，但可于直到现在开刀的瘢痕出口处见一局部肿物，并有周期特质的头痛和水肿。

Figure 12. Endometriosis in a cesarean delivery scar. 布12 ，剖宫产右眼出口处内膜肾脏甲状腺肿

...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 ).背直肌鞘血肿可发生于发作特质咳嗽后、喷嚏或帕金森氏症发作后，其根本原因不一定是抗凝治疗或出血特质疾病。由于血肿受限于背直肌鞘内，不一定不很大，其形状根据所出口处所在位置而定，在弓状支线以上，血肿常以卵圆形，长轴长方形上下路径，可于一侧见到（布13A）；在弓状支线不限，由于背前头缺如，可扩展移向中支线，因此血肿体现为分膨大，其最大长度位处双曲支线上。在婴儿腰椎血肿可载于脐上横向扩展（布13B、C）。术后星体特质血管内心肌的患者可于腰椎开刀瘢痕附近见到大的血肿（布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. 布13A，一中年妇女剧烈咳嗽后背直肌鞘血肿，上标请示背横筋膜。B，婴儿腰椎血肿。C，一婴儿脐微血管附着出口处里面的腰椎血肿。UV，脐微血管。D，一星体特质血管内心肌的剖宫产术后患者鼻子出口处腰椎血肿。

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