小儿腹型过敏性紫癜的高频超声诊断价值探讨

The role of high frequency ultrasound in the diagnosis of abdominal type Henoch-Schnlein purpura

目的 探讨高频彩色多普勒超声检查在小儿腹型过敏性紫癜诊断中的应用价值。方法 回顾性分析45名经临床及实验室检查确诊为过敏性紫癜患儿的超声及临床资料。结果 腹型过敏性紫癜的声像图表现为受累肠管肠壁局限性节段性增厚,肠壁最厚处测值：5～8mm 11例,占24.44%。8～10mm 26例,占57.58%,大于10mm者8例17.78%。肠壁回声不均匀性减低,粘膜层及浆膜层光滑。单发肠管受累者32例,约占71.11%,两处肠管受累者13例,占28.89%。病变位于左中上腹29例,占64.44%,位于右中下腹16例,占35.56%。结论 腹型过敏性紫癜声像图表现有一定特异性,超声检查有助于本病的早期诊断及疗效观察,因其无辐射、无痛苦,简便易行,患儿及家属接受程度高。

Objective To explore the role of high frequency ultrasound in the diagnosis of abdominal type Henoch-Schonlein purpura in child. Methods 45 children admitted to our hospital with the gastrointestinal symptoms were diagnosed to be Henoch- Schonlein purpura by the following clinical and laboratory tests. They all accepted abdominal ultrasonography examination before therapy. Results In all cases, US examinations detected a located and segmental thickening of bowel wall and of variable severity. The thickness of involved intestinal wall was ： 5 ～ 8 mm（ 11 cases, 24.44% ）, 8 - 10 mm （26 cases, 57.58% ）, more than 10 mm （8 cases, 17.78% ）. The intestinal wall infiltrated mostly with internal stratifications, lack of peristalsis. Lesions were multiple （13 cases, 28.89% ） or focal （32 cases, 71.11% ） , 29 cases located in the upper left of the abdomen; 16 cases located in the fight lower quadrant. In CDFI images, the thickening bowel wall were shown abundant color flowing signal. Conclusion Abdominal type Henoeh-Schonlein purpura shows characteristic ultrasonic features and the color Doppler uhrasound is helpful for the early diagnosis and inspecting curative effect. It is safe, simple and easily accepted by children and parents.