超声对儿童脐息肉与脐肉芽肿的鉴别诊断价值

Value of ultrasound in the differential diagnosis of umbilical polyp and umbilical granuloma in children

目的探讨超声对儿童脐息肉与脐肉芽肿的鉴别诊断价值。方法回顾性分析在我院及无锡市儿童医院经手术病理确诊的24例脐息肉患儿(脐息肉组)和40例脐肉芽肿患儿(脐肉芽肿组)的临床及超声检查资料,比较两组声像图特征差异,采用二元Logistic回归分析,纳入回归系数有统计学意义的超声特征建立联合诊断方程;绘制受试者工作特征(ROC)曲线评估各超声特征和联合诊断方程对儿童脐息肉与脐肉芽肿的鉴别诊断效能。结果单因素分析显示,脐息肉组和脐肉芽肿组病灶深度、病灶血供及脐口下方窦道比较差异均有统计学意义(均P<0.05)。将病灶深度、病灶血供及脐口下方窦道纳入回归分析,建立的联合诊断方程为:ln(odds)=-1.376+2.436×病灶深度-2.871×病灶血供+3.074×脐口下方窦道。ROC曲线分析显示,联合诊断方程鉴别儿童脐息肉与脐肉芽肿的敏感性和特异性分别为84.6%和87.2%,曲线下面积为0.873,优于单一超声特征(病灶深度、病灶血供及脐口下方窦道)的曲线下面积(0.694、0.762、0.699),差异均有统计学意义(P=0.018、0.038、0.002)。结论超声可有效鉴别儿童脐息肉与脐肉芽肿,有一定的临床应用价值。

Objective To investigate the value of ultrasound in the differential diagnosis of umbilical polyps and umbilical granuloma in children.Methods The clinical and ultrasonographic data of 24 children with umbilical polyps(umbilical polyps group)and 40 children with umbilical granuloma(umbilical granuloma group)confirmed by pathology in our hospital and Wuxi Children’s Hospital were collected.The differences of sonographic characteristics between the two groups were compared and analyzed.Binary Logistic regression analysis was used to establish a combined diagnostic equation by including the ultrasound characteristics with statistically significant regression coefficient.Receiver operating characteristic(ROC)curve was drawn to assess the ultrasound characteristics and the differential diagnostic efficacy of combined diagnostic equation for umbilical polyp and umbilical granuloma.Results Univariate analysis showed that there were significant differences in lesion depth,lesion blood supply and the sinus tract below the umbilicus between umbilical polyp group and umbilical granuloma group(all P<0.05).The lesion depth,lesion blood supply and sinus tract below the umbilicus were included in the regression analysis,and the established combined diagnostic equation was:ln(odds)=-1.376+2.436×lesion depth-2.871×lesion blood supply+3.074×sinus tract below the umbilicus.ROC curve analysis showed that the sensitivity and specificity of the combined diagnostic equation in differentiating umbilical polyps and umbilical granulomas in children were 84.6%and 87.2%,respectively.The area under the curve was 0.873,which was superior to single ultrasound characteristics(lesion depth,lesion blood supply and the sinus tract below the umbilicus were 0.694,0.762 and 0.699,respectively),and the differences were statistically significant(P=0.018,0.038,0.002).Conclusion Ultrasound can effectively distingush umbilical polyps and umbilical granulomas in children,which has a certain clinical application value.