dxy

Tuberculous abscesses from caries of the ribs can present as palpable lumps per se. They are localized collections of fluid, typically seen around the lower ribs and at or a little inferior to the costal margin (Figure 3A ). They may reveal internal echoes, depending on the debris inside. Destruction of the corresponding rib may be seen on the sonographic examination (Figure 3B ).
源于肋骨溃疡的结核性脓肿表现为可触及肿块，积液集中局限，一般在低位肋骨周围以及肋缘或肋缘稍下可看到（图3A），由于其内部存在碎屑而显示回声。超声检查可见到相应的肋骨破坏。（图3B）

Figure 3. A, Tuberculous abscess inferior to the costal margin. B, Tuberculous abscess surrounding rib caries. Note rib destruction. A indicates abscess.
图3A，肋缘下方结核性脓肿。B，肋骨溃疡周围结核性脓肿。A，脓肿。

Hernias 疝

Hernias are the most common abdominal wall lesions seen in sonographic practice. Depending on their location and cause, they are divided into different categories. With a high-frequency transducer, the fascial defect can be visualized underlying the hernia. Herniated bowel loops have a variable appearance depending on their air-fluid content and degree of obstruction. During the real-time examination, induction and reduction of a hernia can be observed. The patient is asked to cough or perform a Valsalva maneuver while scanning over the suspected site is performed, and with an increase in abdominal pressure, suddenly the hernia will precipitate, and any doubts will be resolved.
在超声检查中疝是最常见的腹壁病变，根据其位置和原因，可进行不同的分类。应用高频探头可清晰的显示疝下的筋膜缺损，疝出的肠管由于气－液含量和梗阻的程度不同而有不同的表现。实时检查过程中可观察到疝的突出和还纳，在可疑位置扫描时可要求病人咳嗽或Valsalva动作，随着腹压增加，疝会突然形成，任何疑问就会迎刃而解。

..Ventral Hernias 腹疝
A ventral hernia occurs typically where there is no muscle support along the linea alba in the midline in the epigastrium (Figure 4 ) or periumbilical region (Figure 5 ). The hernia very often contains only fatty tissue but may be large and contain bowel loops also.
典型的腹疝发生于上腹部中线沿白线而无肌肉支持的部位（图4）或脐周（图5），疝内容物常仅为脂肪组织，但量较大，也可包含肠管。

Figure 4. Ventral hernia with omental fat protruding through the defect in the rectus sheath. Arrows point to the defect in the rectus sheath.
图4。 腹疝，大网膜经缺损的腹直肌鞘突出。箭头指示腹直肌鞘缺损。

Figure 5. A, Periumbilical hernia containing fat. H indicates hernial sac. Arrows point to the defect in the rectus sheath. B, Three-dimensional rendering of a periumbilical hernia containing fat.
图5。A，内含脂肪的脐疝。H，疝囊；箭头指示腹直肌鞘的缺损。B，内含脂肪的脐疝三维图像。

..Spigelian Hernia 半月线疝
A spigelian hernia occurs because of a defect in the aponeurosis of the transverse abdominis muscle and the rectus sheath. The most common site is the point where the linea semilunaris crosses the arcuate line.8,9 The hernia may sometimes extend laterally and present as a flank lump (Figure 6 ).
半月线疝的发生是由于腹横肌腱膜和腹直肌鞘的缺损，最常见的位置在半月线和弓状线的交点处，半月线疝有时向外侧疝出表现为腹侧肿块。

Figure 6. A, Spigelian hernia containing bowel loops. B, Spigelian hernia containing obstructed bowel loops.
图6。A，包含肠环的半月线疝。B，半月线疝包含梗阻的肠管。