CT检查在儿童Meckel’s憩室诊断的应用价值

Value of CT examination for the diagnosis of Meckel's diverticulum in children

目的分析CT平扫及增强检查在儿童Meckel’s憩室诊断的价值。方法回顾性分析2013年~2016年经临床表现及手术病理证实的儿童Meckel’s憩室的临床病史及相关影像资料,具有CT平扫或增强检查的患儿纳入研究,分析CT检查的图像质量(3分法),分析CT影像特点对Meckel’s憩室进行分型,包括囊状(管状)包块型,合并肠梗阻(包括肠套叠)型,合并穿孔周围炎型。结果一共48例患儿(平均4.7岁,男性36例,女性12例)纳入研究。CT检查具有满意的图像质量(平均评分2.7)。通过临床及病理资料,患儿Meckel’s憩室包括囊状(管状)包块型37例,合并肠梗阻(包括肠套叠)型8例,合并穿孔周围炎型3例。CT检出Meckel’s憩室的例数分别为23、8、3,总的检出的准确度70.8%。结论 CT平扫及增强对Meckel’s憩室畸形及其并发症的检出、评价及鉴别诊断提供非常重要的价值。

Objective To analyze the value of unenhanced CT or contrast-enhanced CT in the diagnosis of Meckel＇s diverticulum in children. Methods The clinical history and histopathological data of Meckel＇s diverticulum were analyzed retrospectively from 2013 to 2016. The children with unenhanced CT or contrast-enhanced CT were included in the study. The image quality of CT examination was analyzed using 3-point method. Meckel＇s diverticula were divided into three groups according to their CT features： cystic（ tubular） mass,combined intestinal obstruction（ including intussusception） and combined perforation and around inflammation. Results A total of 48 patients（ mean 4. 7 years,36 males and 12 females） were included in the study. The CT examination had a satisfactory image quality（ mean score 2. 7）. Meckle＇s diverticulum included 37 cases of cystic（ tubular）mass,8 cases of combined intestinal obstruction（ including intussusception） and 3 cases of combined perforation and around inflammation type,according to clinical and pathological data. The number of Meckel＇s diverticulum detected by CT was 23,8,3,respectively,and the total accuracy was 70. 8%. Conclusion Unenhanced and contrast-enhanced CT scan is of great value in the detection,evaluation and differential diagnosis of Meckel＇s diverticulum deformity and its complications.