彩色多普勒超声诊断先天性幽门肥厚性狭窄的价值

Value of Color Doppler Ultrasonography in Diagnosis of Congenital Hypertrophic Pyloric Stenosis

目的探讨高频彩色多普勒超声诊断先天性幽门肥厚性狭窄的价值。方法应用7～11MHz高频探头对临床疑为先天性幽门肥厚性狭窄的50例患儿进行超声检查,观察幽门的形态结构并分别测量幽门肌层的厚度、长度、幽门管腔内径及肥厚幽门肌层的彩色血流速度和多普勒频谱。结果50例临床疑为先天性幽门肥厚性狭窄的患儿,超声测量的各径线均达到了幽门肥厚的诊断标准,且随患儿年龄增大,肥厚更明显;肥厚幽门肌层彩色多普勒的最大血流速度均大于25cm/s,最高达45cm/s,阻力指数RI均大于0.57,最高达0.77。结论应用彩色多普勒超声诊断先天性幽门肥厚性狭窄的准确率达到100%,通过测量彩色血流速度及RI可以用来估计梗阻的轻重程度;简便易行,是诊断此病的首选方法。

Objective To investigate the value of high prefrequency color doppler ultrasonography in diagnosis of congenital hypertrophic pyloric stenosis. Methods A total of 50 sidk children suspected as congenital hypertrophic pyloric stenosis in clinic were examinated with 7～11MHz linear array transducer.The morhpology and structures of pyloris were observed. the thickness and length of pyloric muscular layer as well as the inner diameter of the pyloric canal and Color Doppler flow index(CDFI) and the spectra of hypertropic pyloric muscular layer were measured. Results Viscera ID values by the ultrasonic measurement of 50 sick children suspected with congenital hypertrophic pyloric stenosis in clinic were all conform to diagnostic standard of pyloric thickening,and the more thickening,the more obvious with the increase of age,which were confirmed by operation. Peak velocities (Vmax) of CDFI in hypertropic pyloric musxular layer were all greater than 25cm/s,one of the highest was 45cm/s.RI were all greater than 0.57,and the highest one was 0.77. Conclusions The accuracy rate reached to 100% on color doppler ultrasound in diagnosing congenital hypertrophic pyloric stenosis.We can estimate the obstructive degree by measuring color doppler flow velocity and RI. Color doppler ultrasound is convenient, available and can prevent from X-ray irradiation,So it is a preferable method in diagnosing congenital hypertrophic pyloric stenosis.