超声在先天性肠旋转不良及中肠扭转诊断中的价值

Value of ultrasound in the diagnosis of congenital intestinal malrotation and midgut vovulus

目的探讨超声在诊断先天性肠旋转不良及中肠扭转中的价值。方法回顾性分析161例临床高度怀疑肠旋转不良患儿的超声结果，并与手术、上消化道造影结果进行对比分析。结果对于临床高度怀疑肠旋转不良的患儿，超声提示肠旋转不良的敏感性为82％，特异度性为94％；超声提示中肠扭转的敏感性为94％，特异性为94％。结论对于临床高度怀疑肠旋转不良的患儿，肠系膜上静脉位于肠系膜上动脉左侧的超声阳性征象，能够强烈提示肠旋转不良；超声顺时针旋转的漩涡征可强烈提示肠扭转。

Objective To evaluate the value of ultrasound in the diagnosis of congenital intestinal malrotation and midgut vovulus. Methods The findings of ultrasound of 161 children with clinically suspected intestinal malrotation were analysed retrospectively, and were compared with the results of the operation and/or the upper gastrointestinal contrast study. Results The positive sign of ultrasound for congenital intestinal malrotation was that the superior mesenteric vein（SMV） being located at the left of the superior mesentery artery（SMA）, or being directly anterior to the SMA, and the positive sign ~or midgut vovulus was clockwise whirlpool sign （clockwise rotation of the small bowel, its mesentery and the SMV around the SMA）. The sensitivity of ultrasound for congenital intestinal malrotation was 82~, and the specificity was 94~. Those for midgut vovulus were 94~ and 94~ respectively. Conclusions Special sign as the superior mesenteric vein（SMV） being located at the left of the superior mesentery artery（SMA） strongly indicate congenital intestinal malrotatione, and the clockwise whirlpool sign means great possibility of midgut vovulus.