高频超声在儿童常见急腹症诊断中的应用

Common in children of high frequency ultrasound diagnosis of acute abdomen

目的探讨肠套叠、急性阑尾炎、肠系膜淋巴结炎3种常见疾病的超声表现以提高高频超声诊断的准确率。方法对肠套叠65例、急性阑尾炎58例、肠系膜淋巴结炎50例3组患儿的超声表现进行总结回顾,分析形态学特点,评价诊断的准确性。结果肠套叠组:均出现"靶环征"的特征性超声表现。急性阑尾炎组:单纯性阑尾炎43例中13例未有阳性超声表现,30例出现"手指状"肿大的阑尾,合并粪石4例;合并肠系膜淋巴结肿大11例;化脓性阑尾脓肿15例。肠系膜淋巴结炎组:单个肿大8例;散在多发性14例;串珠样排列28例,肿大淋巴结长轴直径>10 mm,短轴直径>5 mm,纵横比≥2。淋巴门可见彩色血流信号。结论高频超声对肠套叠、急性阑尾炎、肠系膜淋巴结炎的检查具有特征性的表现,对临床的诊断和治疗具有很好的指导作用。

Objective To investigate the ultrasonography of three common diseases-intussusception,acute appendicitis and mesenteric lymphadenitis,and improve the diagnostic accuracy of high frequency ultrasound.Methods 65 cases of intussusception,58 cases of acute appendicitis,mesenteric lymphadenitis,50 cases of mesenteric lymphadenitis children,were summarized and retrospectively analyzed of morphological characteristics,evaluation of diagnostic accuracy.Results Intussusception group： had a ＇target ring sign＇ of the performance characteristics of ultrasound.Acute appendicitis group： 43 patients with simple appendicitis,13 patients without positive ultrasonography,30 cases with a ＇finger-like＇ swelling of the appendix,4 cases with combined fecal;combined mesenteric lymph nodes were observed in 11 cases;15 cases with purulent appendicular abscess.Mesenteric lymphadenitis group： 8 cases with individual nodes;scattered in multiple in 14 cases;beaded arranged in 28 cases,Long axis diameter of lymph nodes10mm,short axis diameter5mm,aspect ratio≥2.Hiler visible color flow signal.Conclusion High-frequency ultrasound of intussusception,acute appendicitis,mesenteric lymphadenitis has a characteristic ultrasonoographic appearance,which can serve as a good guide in clinical ediagnosis and treatment.