超声在儿童结肠息肉诊断中的应用价值

The application value of sonographic diagnosis in the children with colonic polyps

目的探讨超声对儿童结肠息肉的诊断价值及其超声声像图特征。方法回顾性分析342例术前进行超声检查并经结肠镜及病理证实的结肠息肉患儿的超声表现。结果 342例患儿中男244例,女98例。224例(65.5%)患儿发病年龄为3～6岁。单发息肉333例,位于乙状结肠226例,直肠41例,余段结肠66例。多发息肉9例,共33枚。息肉最大5.3cm×1.7cm×3.1cm,最小0.6cm×0.5cm×0.5cm。超声诊断332例(97.1%),超声表现均为中等回声结节,其内部可探及小囊腔且CDFI血供丰富,可探及蒂血流及息肉内部树枝状血流。<1cm的息肉囊腔及蒂结构不明显,但CDFI可探及明确的血流信号。16例患儿超声检出合并继发肠套叠,表现为同心圆征象,套入起始部肠腔内可探及息肉回声。其中14例患儿息肉位于降结肠及结肠脾曲。结论超声诊断儿童结肠息肉方便、无创、无放射性且检出率高,是血便患儿首选检查方法。结肠息肉超声声像图具有特异性,不易与其他病变混淆,在儿童一般不需鉴别诊断。

Objective To assess the ability of transabdominal ultrasound to detect children with colonic polyps and describe their uhrasonographie appearance. Method The location of colonic polyps in 342 subjects and their ultrasonographic characteristics diagnosed by ultrasonographic examination were summa- rized before eolonoscopy and were diagnosed pathological examination. Results A total of 333 children had only one polyp that were located in sigmoid colon of 226 subjects, rectal of 41 subjects, and 66 cases in the rest part of colon. Nine children have more than one polyps. The polyps were measured with 5 to 50 mm in diameter. The polyp was observed presented as a solid, hypoechoic intra luminal nodule. Within this nodule there were a variable number of small cystic spaces. Blood flow was easily identified within these polyps by color Doppler sonography, which may facilitate the identification of a vascular pedicle coursing through the stalk of the polyp as well. Sixteen eolocolonie intussusceptions were observed in which the polyps acted as a concentric circle. Of 14 cases were located at the descent colon and splenic flexure of colon. Conclusion Ultrasonographic examination is noninvasive and free of radiation with high efficiency, which can visualize the polyp. The sonography may be the first diagnosis choice in the evaluation of children with bleeding stool. The polyps in children have a characteristic appearance and need not differential diagnosis.