彩色多普勒超声对90例小儿肠套叠的诊断分析

Color Doppler ultrasound diagnosis of pediatric intussusception in 90 children

目的探讨小儿肠套叠的彩色多普勒超声影像特征及其临床诊断价值。方法选取2015年12月至2017年12月收治的疑似肠套叠患儿90例作为研究对象,所有患儿均经彩色多普勒超声和X线检查。参照手术或临床综合诊断结果,比较两种检查方法的检出率,并总结肠套叠的超声表现。结果 90例患儿均经手术治疗后证实为小儿肠套叠,X线检出率82.22%(74/90),低于彩色多普勒超声的93.33%(84/90),差异有统计学意义(P<0.05)。90例患儿中彩色多普勒超声检查漏诊6例,84例明确诊断为肠套叠,超声征象为纵切面呈"套筒征"和横切面呈"同心圆征",彩色多普勒显示"套筒征"内肠系膜星点状血流信号及动、静脉频谱,近端血流信号较远端血流信号稀疏,肠管发生坏死者无彩色血流信号。结论彩色多普勒超声诊断小儿肠套叠具有较高的疾病检出率,可为临床的及时治疗提供可靠参考。

Objective To investigate the clinical value of color Doppler ultrasound（ CDUS） in the diagnosis of pediatric intussusception. Methods A total of 90 children with suspected pediatric intussusception treated from December 2015 to December 2017 were selected as the research objects. All children were given CDUS and X-ray examination. Referring to the surgical results,the detection rates by two examination methods were compared,and the ultrasonic findings of intussusception were analyzed. Results All children were confirmed by pediatric intussusception after surgery or clinical comprehensive diagnosis,and the detection rate of X-ray was 82. 22%（ 74/90） was significantly lower than that [93. 33%（ 84/90） ]of CDUS（ P〈0. 05）. In 84 cases clearly confirmed by CDUS,the ultrasonography showed sleeve sign in vertical section and concentric circle sign in cross section. In ＂sleeve sign＂,CDUS showed that there were mesenteric star-like blood flow signals and arterial or venous frequency spectrum,more sparse signal in proximal blood flow compared with distal blood flow,and no color Doppler flow signal in bowel necrosis. Conclusion CDUS diagnosis has a higher detection rate for pediatric intussusception,which can provide reliable basis for timely clinical treatment.