腹壁可触及肿物的成像鉴别（二）

Miscellaneous Lesions 其他病变.. Urachal Cyst 胃尿管肺部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 )胃尿管肺部可知胃和输尿管之间，往往设在胃尿管的下1/3 ，但也可可知非常少设在胃下。这些肺部可体现为无论如何无回音或高于回音。

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，胃尿管肺部，此肺部已受接种，内部含有相比之下回音的液体。B，胃尿管肺部，紧绷的肺部前壁产生反射伪影。

..Endometriosis胎盘血管壁异位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 ).纵隔胎盘血管壁异位是胎盘康复的长期合并症，无特殊体现，但可于那时候手术的瘢痕出口处见一全局肿物，并有周期特质的呼吸困难和肿胀。

Figure 12. Endometriosis in a cesarean delivery scar. 所示12 ，剖宫产脸上出口处胎盘血管壁异位

...Abdominal Wall Hematoma 纵隔血肿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 ).腹直肌鞘血肿可发生于中风特质呼吸困难后、不由自主或癫痫中风后，其根本原因往往是抗凝治疗或出血特质疾病。由于血肿限制于腹直肌鞘内，往往不极大，其圆形根据所出口处右边而定，在弓状终点站以上，血肿常为椭圆形，长轴呈上下方向，可于一侧碰见（所示13A）；在弓状终点站以下，由于腹白终点站缺如，可拓展行进中终点站，因此血肿体现为分齿状，其最小较宽设在横轴上。在新生儿纵隔血肿可可知胃上垂直拓展（所示13B、C）。术后不规则特质心肌内凝血的病者可于纵隔手术瘢痕不远处碰见大的血肿（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，一中年妇女剧烈呼吸困难后腹直肌鞘血肿，箭头指示腹横筋膜。B，新生儿纵隔血肿。C，一新生儿胃肾脏吸附出口处上面的纵隔血肿。UV，胃肾脏。D，一不规则特质心肌内凝血的剖宫产术后病者额头出口处纵隔血肿。

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