超声与X线诊断新生儿十二指肠隔膜症的对比分析

Contrast analysis of gastrointestinal ultrasonography and X-ray radiolography in diagnosis of neonatal duodenal septum

目的探讨对十二指肠隔膜症患儿应用胃肠道超声造影与X线上消化道造影诊断的临床效果。方法选取2016年3月至2019年12月期间在广州市妇女儿童医疗中心进行手术确诊的十二指肠隔膜症新生儿共19例,所有患儿均以上消化道梗阻入院,手术前均进行胃肠道超声造影与X线上消化道造影检查,回顾性分析两种检查方式的诊断准确率。结果胃肠道超声造影对于十二指肠梗阻诊断符合率、定位准确率要高于X线上消化道造影(100.0%vs.89.5%,89.5%vs.68.4%),但差异不具有统计学意义(均P>0.05);胃肠道超声造影的定性准确率显著高于X线上消化道造影(63.2%vs.21.1%),差异具有统计学意义(χ^2=6.909,P<0.05)。19例患儿中合并症者有3例,分别为合并肠旋转不良1例、合并环状胰腺2例。胃肠道超声造影检查出1例合并症,而X线上消化道造影均漏诊。结论结合超声造影定性的高准确率及对于合并症的诊断优势,建议可以把胃肠道超声造影作为新生儿十二指肠隔膜症的首选检查方法,与X线上消化道造影互补,为该病的临床诊治提供更准确的影像学依据。

Objective To investigate clinical effects of gastrointestinal contrast-enhanced ultrasonography and X-ray contrast of upper digestive tract in diagnosis of neonatal duodenal septum.Methods A total of 19newborns with duodenal septum diagnosed by surgery at Guangzhou Municipal Women and Children's Medical Center from March 2016to December 2019were selected.All newborns were admitted to the hospital due to digestive tract obstruction.Gastrointestinal contrast-enhanced ultrasonography and X-ray contrast examination of upper digestive tract were performed on the newborns before the surgery.The diagnostic accuracy of the two examination methods for the disease was analyzed and compared.Results The diagnostic accordance rate and accuracy of duodenal obstruction by gastrointestinal contrast-enhanced ultrasonography were higher than those by X-ray contrast of upper digestive tract(100.0%vs.89.5%and 89.5%vs.68.4%respectively),but the differences were not statistically significant(both P>0.05).The qualitative diagnostic accuracy of gastrointestinal contrast-enhanced ultrasonography was significantly higher than that of X-ray contrast of upper digestive tract(63.2%vs.21.1%),and the difference was statistically significant(χ^2=6.909,P<0.05).Among 19patients,3patients had some complications,including intestinal malrotation in 1case and annular pancreas in 2cases.Contrastenhanced ultrasonography of the gastrointestinal tract revealed 1case of complication,while all complications were missed by X-ray contrast examination of upper digestive tract.Conclusion Owing to high qualitative diagnostic accuracy of contrast-enhanced ultrasonography and its advantages in diagnosis of the complications of neonatal duodenal septum,it is suggested that gastrointestinal contrast-enhanced ultrasonography can be used as first-chosen examination method of neonatal duodenal septum,which is complementary to X-ray contrast of upper digestive tract and provides a more accurate imaging basis for clinical diagnosis and treatment of this disease.