腹部超声与X线平片在肠套叠筛查诊断中的比较研究

Comparative Study of Abdominal Ultrasonography and X-ray Plain Film in Screening and Diagnosis of Intussusception

目的探讨超声与X线平片在肠套叠诊断及筛查中的应用价值。方法选取我院2013年1月至2016年1月期间收治的疑似肠套叠患者180例作为研究对象,经行超声及X线平片检查。以手术、空气灌肠、住院及随访病理结果为标准,比较两种检查方法的诊断准确性及影像学征象。结果 180例患者中,手术、空气灌肠、住院及随访病理结果确诊171例(儿童126例、成人45例)为肠套叠患者,其中52例在右上腹、32例在左上腹、24例在中上腹、25例在右侧腹、38例在右下腹。超声诊断结果为164例为肠套叠患者、漏诊7例,准确性达95.91%(164/171);X线平片诊断结果为92例为肠套叠患者、漏诊79例,准确性为53.80%(92/171),差异有统计学意义(P<0.05)。X线平片结果显示儿童与成人中肠气体稀少、腹部充气肠管、腹部液气平面、软组织块影征象发生率均接近,差异无统计学意义(P>0.05)。超声检查结果显示儿童中"同心圆征"、"套筒征"、腹腔淋巴结征象发生率明显高于成人,差异有统计学意义(P<0.05);而假肾征、包块及周围淋巴结、腹腔积液、无色彩血流发生率比较差异无统计学意义(P>0.05)。结论超声检查对肠套叠的诊断较X线平片检查具有更高的准确性,可作为肠套叠诊断的常规方法,对儿童肠套叠患者诊断则可作为首选检查方法。

Objective To investigate the value of ultrasonography and X-ray plain film in the diagnosis and screening of intussusception. Methods 180 patients suspected intussusception who were treated in our hospital from January 2013 to January 2016 were selected as the subjects,and all patients were underwent ultrasonography and X-ray examination. The diagnostic accuracy and imaging findings of the two methods were compared by the results of operation,air enema,hospitalization and follow-up. Results Among 180 patients,171 cases（ 126 children,45 adults） were diagnosed as intussusception by the results of operation,air enema,hospitalization and follow-up,and there were 52 cases of right upper abdomen,32 cases of left upper abdomen,24 cases of middle upper abdomen,25 cases of right abdomen,38 cases of right lower abdomen. The results of ultrasonic diagnosis were that 164 cases were intussusception,7 cases were missed diagnosis,and the accuracy was 95. 91%（ 164/171）,the X-ray diagnostic results were that 92 cases were intussusception,79 cases were missed diagnosis,the accuracy was 53. 80%（ 92/171）,and the difference was statistically significant（ P0. 05）. X-ray film showed that the incidence of intestinal gas in children and adults was low,and the incidence of abdominal gas,intestine and abdominal fluid,gas plane and soft tissue block were close,and the difference was not statistically significant（ P0. 05）. The results of X-ray plain film showed that the incidence of midgut gas sparse,abdominal inflation tube,abdominal fluid gas level,soft tissue shadow in children and adults were close,and the difference was not statistically significant（ P 0. 05）.The results of ultrasonic examination showed that the incidence of concentric circle sign,sleeve sign and abdominal lymph node sign in children was higher than that in adults,the difference was statistically significant（ P0. 05）,there was no significant difference in the incidence of false renal sign,mass and peripheral lymph nodes,peritoneal effusion,and color free blood flow（ P0. 05）. Conclusion The diagnosis of intussusception by ultrasonography is more accurate than X-ray examination,ultrasonography can be used as a routine method for the diagnosis of intussusception,and it can be used as the first choice in children.