影像科学与光化学 ›› 2022, Vol. 40 ›› Issue (6): 1586-1590.DOI: 10.7517/issn.1674-0475.220817

• 综述与论文 • 上一篇    下一篇

CT联合HFUS对小儿肠套叠诊断及复位的评估研究

郭建康1, 柏艳红1, 梁优1, 刘雅娜1, 许华2   

  1. 1. 三二〇一医院超声医学科, 陕西 汉中 723000;
    2. 三二〇一医院医学影像科, 陕西 汉中 723000
  • 收稿日期:2022-08-10 出版日期:2022-11-23 发布日期:2022-11-15
  • 通讯作者: 郭建康

Evaluation of CT Combined with HFUS in the Diagnosis and Reduction of Intussusception in Children

GUO Jiankang1, BAI Yanhong1, LIANG You1, LIU Yana1, XU Hua2   

  1. 1. Ultrasound Medicine Department, 3201 Hospital, Hanzhong 723000, Shaanxi, P. R. China;
    2. Medical Imaging Department, 3201 Hospital, Hanzhong 723000, Shaanxi, P. R. China
  • Received:2022-08-10 Online:2022-11-23 Published:2022-11-15

摘要: 本研究探讨CT联合高频超声(HFUS)检查在诊断小儿肠套叠及评估复位效果中的价值。选取91例疑似肠套叠患儿进行临床研究,其中,67例经临床确诊为肠套叠(观察组)、24例经临床确诊为急性阑尾炎、闭孔疝等疾病(对照组)。所有患儿入院后均接受了腹部HFUS、CT检查,分析两组患儿上述影像学资料,观察两种方法单独及联合应用在鉴别诊断肠套叠患儿中的价值及评估复位效果的能力。观察组患儿的同心圆征、假肾形征检出率均显著高于对照组患儿(P<0.05);观察组患儿的靶形肿块征、彗星尾征、肾形肿块特征检出率均显著高于对照组患儿(P<0.05)。67例确诊肠套叠患儿,其中61例采用温生理盐水成功复位、6例温生理盐水复位失败后采用外科手术治疗。成功复位患儿的套叠肠管长度、套叠肠管厚度测定值均低于失败的患儿(P<0.05);复位成功患儿的回肠横断面超声表现为类葡萄征、铜钱样检出率高于失败组(P<0.05)。CT与HFUS联合诊断肠套叠患儿的灵敏度为95.52%、特异度为91.67%。根据腹部CT特征联合腹部HFUS声像特征诊断肠套叠患儿能显著提高灵敏度和特异度,并且能评估患儿采用温生理盐水复位的效果。

关键词: CT, 高频超声, 诊断, 小儿, 肠套叠, 复位效果

Abstract: This study investigated the value of CT combined with high-frequency ultrasonography (HFUS) in diagnosing intussusception and evaluating the effect of reduction in children. A total of 91 children with suspected intussusception were selected for clinical study, of which 67 cases were clinically diagnosed as intussusception (observation group), 24 cases were clinically diagnosed as acute appendicitis, obturator hernia and other diseases (control group). All children received abdominal HFUS and CT examination after admission. The above imaging data of the two groups of children were analyzed. The value of the two methods alone and in combination in the differential diagnosis of children with intussusception and the ability to evaluate the effect of reduction were observed. The detection rates of concentric circle sign and pseudo-kidney sign in the observation group were significantly higher than those in the control group (P<0.05). The incidence rates of target-shaped mass, comet-tail and kidney-shaped mass in the observation group were significantly higher than those in the control group (P<0.05). 67 children with confirmed intussusception, 61 cases were successfully reset with warm normal saline, and 6 cases were treated with surgery after the failure of warm normal saline reset. The measured values of the length and thickness of the intussusception in children with successful reduction were lower than those in children with failure (P<0.05). The ileum cross-sectional ultrasound of the children with successful reduction showed grape-like sign and the detection rate of copper coins were higher than those of the failure group (P<0.05). The sensitivity and specificity of CT combined with HFUS in diagnosing children with intussusception were 95.52% and 91.67%, respectively. Diagnosing children with intussusception based on abdominal CT features combined with abdominal HFUS sonographic features can significantly improve the sensitivity and specificity, and can evaluate the effect of repositioning with warm normal saline in children.

Key words: CT, high frequency ultrasound, diagnosis, children, intussusception, reduction effect