高频超声联合低频超声诊断小儿肠套叠的价值

Value of high frequency ultrasound combined with low frequency ultrasound in diagnosis of intussusception in children

目的分析高频超声联合低频超声诊断小儿肠套叠的临床价值。方法抽取2019年1月至2022年10月郑州大学第一附属医院收治的79例疑似小儿肠套叠患儿作为研究对象,均行高频超声和低频超声检查,以超声监测下水压灌肠结果为"金标准",对比高频超声、低频超声单独和联合诊断小儿肠套叠的诊断效能、预测值、不同位置肠套叠检出率。结果79例疑似小儿肠套叠患儿,超声监测下水压灌肠结果显示肠套叠57例,非肠套叠22例;高频超声诊断出阳性47例(真阳性46例,假阳性1例),阴性32例(真阴性21例,假阴性11例);低频超声诊断出阳性45例(真阳性42例,假阳性3例),阴性34例(真阴性19例,假阴性15例);高频超声联合低频超声诊断出阳性60例(真阳性57例,假阳性3例),阴性19例(真阴性19例,假阴性0例)。高频超声联合低频超声的诊断灵敏度(100.00%,57/57)、准确度(96.20%,76/79)高于高频超声单独诊断(80.70%,46/57;84.81%,67/79)和低频超声单独诊断(73.68%,42/57;77.22%,61/79),联合诊断漏诊率(0.00%,0/57)低于高频超声(19.30%,11/57)和低频超声(26.32%,15/57),P<0.05。高频超声联合低频超声诊断阴性预测值(100.00%,19/19)高于高频超声单独诊断(65.63%,21/32)和低频超声单独诊断(55.88%,19/34),P<0.05。高频超声联合低频超声的回盲瓣检出率(100.00%,51/51)高于高频超声诊断(78.43%,40/51)、低频超声诊断(74.51%,38/51),P<0.05。结论高频超声联合低频超声诊断小儿肠套叠可提高诊断效果并明确病变部位,可为临床诊疗提供指导。

Objective To analyze the clinical value of high frequency ultrasound combined with low frequency ultrasound in diagnosis of intussusception in children.Methods Seventy-nine children with suspected intussusception treated in the First Affiliated Hospital of Zhengzhou University from January 2019 to October 2022 were selected as subjects,and all of them underwent high frequency ultrasound and low frequency ultrasound.Using the results of ultrasound monitoring on hydraulic enema as the gold standard,the efficacy in diagnosis of intussusception in children,predictive value and detection rate of intussusception at different locations of high frequency ultrasound,low frequency ultrasound alone and combination of the two methods were compared.Results Among 79 children suspected with intussusception in the study,the results of ultrasonic monitoring on hydraulic enema showed 57 cases of intussusception and 22 cases of non-intussusception.There were 47 positive cases(46 true positive cases,1 false positive case)and 32 negative cases(21 true negative cases,11 false negative cases)diagnosed by high frequency ultrasound.There were 45 positive cases(42 true positive cases,3 false positive cases)and 34 negative cases(19 true negative cases,15 false negative cases)diagnosed by low frequency ultrasound.High frequency ultrasound combined with low frequency ultrasound identified 60 positive cases(57 true positive cases,3 false positive cases)and 19 negative cases(19 true negative cases,0 false negative case).The sensitivity and accuracy of high frequency ultrasound combined with low frequency ultrasound(100.00%,57/57;96.20%,76/79)were higher than those of high frequency ultrasound alone(80.70%,46/57;84.81%,67/79)and low frequency ultrasound alone(73.68%,42/57;77.22%,61/79),moreover,the missed diagnosis rate of combined diagnosis(0.00%,0/57)was lower than that of high frequency ultrasound(19.30%,11/57)and low frequency ultrasound(26.32%,15/57),P<0.05.The negative predictive value of high frequency ultrasound combined with low frequency ultrasound(100.00%,19/19)was higher than that of high frequency ultrasound alone(65.63%,21/32)and low frequency ultrasound alone(55.88%,19/34),P<0.05.The detection rate of high frequency ultrasound combined with low frequency ultrasound(100.00%,51/51)was higher than that of high frequency ultrasound diagnosis(78.43%,40/51)and low frequency ultrasound diagnosis(74.51%,38/51)in the diagnosis of ilececal valve(P<0.05).Conclusions High frequency ultrasound combined with low frequency ultrasound can improve the diagnostic effect and clarify the location of the disease in children with intussusception,which can provide guidance for clinical diagnosis and treatment.