空气灌肠、经腹壁彩超与CT平扫对小儿肠套叠的诊断及临床应用价值分析

Diagnosis and Clinical Application of Air Enema, Transabdominal Color Doppler Ultrasonography and CT Plain Scan in Children with Intussusception

目的对比空气灌肠、经腹壁彩超与CT平扫对小儿肠套叠的诊断及临床应用价值。方法选取2013年1月至2018年1月于我院就诊治疗的肠套叠患儿174例,其中符合标准的59例患儿均行空气灌肠、经腹壁彩超与CT平扫检查,收集59例肠套叠患者的临床资料及影像学资料,总结并计算不同检查方式诊断肠套叠灵敏度、特异度。结果空气灌肠、经腹壁彩超与CT平扫诊断小儿肠套叠的灵敏度分别为84.74%、94.91%、96.61%,空气灌肠诊断小儿肠套叠的灵敏度低于经腹壁彩超、CT平扫(P<0.05);注入气体后可见充气结肠远端出现不同形态高密度软组织,呈现杯状、圆柱状;经腹壁胃肠超声中肠套叠区域边界较为清晰,短轴切面呈现"同心圆"或"靶环"征,"同心圆"直径<30mm,彩色多普勒则多呈现"套筒"征,远端血流信号较为丰富,血流信号Ⅲ级~Ⅳ级者53例;CT平扫主要表现为"靶征"、"肾形征"。结论经腹壁胃肠彩超与CT平扫诊断小儿肠套叠灵敏度较好,应用空气灌肠复位肠套叠效果较佳。

Objective To compare the diagnostic and clinical value of air enema, transabdominal color Doppler ultrasonography and CT plain scan in children with intussusception. Methods 174 children with intussusception who were treated in our hospital from January 2017 to April 2018 were selected. Among them, 59 patients who met the standard underwent air enema, transabdominal color Doppler ultrasonography and CT scan. The clinical and imaging data of 59 cases of intussusception were collected. The sensitivity and specificity of different examinations were calculated for the diagnosis of intussusception. Results There was no significant difference in the specificity of air enema, transabdominal color Doppler ultrasonography and CT plain scan in the diagnosis of intussusception in children(P>0.05). The sensitivity of air enema, transabdominal color Doppler ultrasonography and CT plain scan in the diagnosis of intussusception in children was 84.74%, 94.91% and 96.61%, respectively. The sensitivity of air enema in the diagnosis of intussusception in children was lower than that of transabdominal color Doppler ultrasonography and CT plain scan(P<0.05). After injecting the gas, highdensity soft tissue with different forms appeared in the distal end of the pneumocolon, which showed cup-shaped and cylindrical shape. In the transabdominal gastrointestinal ultrasound, the boundary of the intussusception area was relatively clear, the section of short axis presented a "concentric circle" or "target ring" sign, the diameter of "concentric circle" was <30 mm, and the color Doppler presented a "sleeve" sign. The distal blood flow signal was abundant, and the blood flow signal was grade Ⅲ~Ⅳ in 53 cases;the CT plain scan mainly showed "target sign" and "kidney shape sign". Conclusion The sensitivity of transabdominal gastrointestinal color Doppler ultrasonography and CT plain scan in the diagnosis of intussusception in children is better, and the effect of air enema for reduction of intussusception is better.