高频彩色多普勒超声对胆道闭锁的诊断价值

Value of high-frequency color Doppler ultrasonography in diagnosis of biliary atresia

目的探讨高频彩色多普勒超声在胆道闭锁诊断中的临床价值。方法对婴儿胆道闭锁组32例、婴儿肝炎综合征组30例行高频彩色多普勒超声检查。观察其胆囊的大小及形态结构、肝动脉内径、肝被膜下血流。结果胆道闭锁组胆囊长径平均值为(15.4±7.3)mm,明显小于肝炎综合征组的(29.0±6.1)mm(P<0.01);而胆道闭锁组肝动脉内径平均值为(2.0±0.4)mm,明显大于肝炎综合征组的(1.2±0.4)mm(P<0.01);以肝动脉内径1.45mm为临界点,曲线下面积为0.92,与金标准比较,诊断胆道闭锁的敏感度、特异度、准确度分别为90.63%、90.00%、90.32%;肝被膜下血流阳性诊断胆道闭锁的敏感度、特异度、准确度分别为93.75%、90.00%、91.94%。结论高频彩色多普勒超声对胆道闭锁的早期诊断及鉴别诊断有重要的价值。

Objective To investigate the clinical value of high-frequency color Doppler ultrasonography in diagnosis of biliary atresia.Methods Thirty-two patients diagnosed with biliary atresia,and 30 neonatal hepatitis patients were examined by high-frequency color Doppler ultrasonography.The gallbladder morphology and length,hepatic artery diameter and ultrasonic hepatic subcapsular were observed.Results The length of the gallbladder in biliary atresia group（15.4±7.3）mm was significantly smaller than that of the neonatal hepatitis group（29.0±6.1）mm（P〈0.01）;The diameter of the hepatic artery in biliary atresia group（2.0±0.4）mm was significantly larger than that of the neonatal hepatitis group（1.2±0.4）mm（P〈0.01）.The optimal cut-off value for the prediction of biliary atresia was 1.45 mm for hepatic artery diameter,the area under the curve was 0.92.Compared with the gold standard,the sensitivity,specificity and accuracy in diagnosis of biliary atresia were 90.63%,90.00% and 90.32%,respectively;in the diagnosis of biliary atresia with positive blood under the liver capsule,the sensitivity,specificity,accuracy were respectively 93.75%,90.00% and 91.94%.Conclusion Highfrequency color Doppler ultrasonography has important value for early diagnosis and differentialdiagnosis of biliary atresia.