腹部超声对儿童Peutz-Jeghers综合征及其继发肠套叠的诊断价值

Diagnostic value of abdominal ultrasound in children with Peutz-Jeghers syndrome and its secondary intussusceptions

目的探讨腹部超声在儿童Peutz-Jeghers综合征(PJS)及其继发肠套叠中的诊断价值。方法收集我院经内镜或外科手术证实的25例PJS患儿,分析超声对本病的诊断准确率及声像图特点。结果本组共25例患儿,男女比例为3∶2。消化道内镜或手术发现97枚息肉,共合并19例肠套叠,超声发现82枚息肉及18例肠套叠,超声对息肉及继发肠套叠的诊断准确率分别为84%、95%。25例患儿中3例为单发息肉,均位于小肠,其中1例继发肠套叠,余22例为多发息肉,54枚位于小肠,其中18例继发肠套叠。息肉超声表现为中等、稍低或高低混杂回声,部分病变内可见强回声钙化。继发肠套叠超声表现为套环内肠壁明显水肿增厚、回声减低,“同心圆”征或“花瓣征”为其特征性表现。结论儿童PJS临床少见,超声检查具有无创、安全、方便、可重复及诊断准确率较高等优点,对PJS及继发肠套叠具有重要的应用价值,可用于本病的诊断、筛查及随访工作。

Objective To investigate the diagnostic value of abdominal ultrasound in children with peutz-jeghers syndrome(PJS)and its secondary intussusception.Methods Twenty-five cases′children with PJS confirmed by endoscopy or surgery in our hospital were collected,and the diagnostic accuracy and sonogram characteristics of this disease were analyzed.Results The ratio of male to female was 3∶2.Ninety-seven polyps were found by gastrointestinal endoscopy or surgery,and a total of 19 cases with intussusception were found.Eighty-two polyps and 18 cases with intussusception were found by ultrasound.The diagnostic accuracy of ultrasound for polyps and secondary intussusception was 84%and 95%,respectively.Among the 25 cases,3 cases had single polyps,all of which were located in the small intestine,among which 1 case had secondary intussusception,the remaining 22 cases had multiple polyps,54 of which located in the small intestine,and 18 cases had secondary intussusception.Polyp ultrasound showed moderate,slightly low or high and low mixed echo,and some lesions showed strong echo calcification.The secondary intussusception was characterized by obvious edema and thickening of the inner intestinal wall and decreased echo.Conclusion PJS in children is rare in clinic.Ultrasound examination has the advantages of non-invasive,safe,convenient,repeatable and high diagnostic accuracy.It has important application value for PJS and secondary intussusception.