高频超声联合低频超声诊断小儿肠套叠的效能分析

Value of high-frequency ultrasound combined with low-frequency ultrasound in the diagnosis of intussusception in children

目的分析高频超声联合低频超声诊断小儿肠套叠的效能。方法抽取2019年6月至2020年8月濮阳市妇幼保健院收治的疑似小儿肠套叠患儿84例,均予以高频超声、低频超声及二者联合检查,以X线钡灌肠检查为"金标准"。结果本组84例疑似小儿肠套叠患儿,经X线钡灌肠检查确诊阳性63例,阴性21例;采用高频超声诊断出真阳性48例,真阴性16例;采用低频超声诊断出真阳性40例,真阴性14例;采用二者联合诊断出真阳性57例,真阴性18例;高频超声、低频超声二者联合诊断特异度(85.71%,18/21)、误诊率(14.29%,3/21)与高频超声(76.19%,16/21;23.81%,5/21)及低频超声单独诊断(66.67%,14/21;33.33%,7/21)比较差异未见统计学意义(P>0.05);高频超声、低频超声二者联合诊断灵敏度、准确度(90.48%,57/63;89.29%,75/84)高于高频超声(76.19%,48/63;76.19%,64/84)及低频超声单独诊断(63.49%,40/63;64.29%,54/84),漏诊率(9.52%,6/63)低于高频超声(23.81%,5/21)和低频超声单独诊断(36.51%,23/63),P<0.05。高频超声、低频超声二者联合对同心圆征、混合性肿块及肠壁水肿等肠套叠典型声像征检出率均高于高频超声及低频超声的检出率(P均<0.05);高频超声、低频超声联合诊断不同部位肠套叠检出率高,但与二者单独诊断组间比较差异未见统计学意义(P>0.05)。结论高频超声联合低频超声诊断小儿肠套叠具备较高的准确性,可为临床诊治提供有效的科学依据。

Objective To analyze the value of high-frequency ultrasound combined with low-frequency ultrasound in the diagnosis of intussusception in children.Methods A total of 84 children with suspected pediatric intussusception treated in Puyang Maternal and Child Health Hospital from June 2019 to August 2020 were selected.All of them were examined by high-frequency ultrasound,low-frequency ultrasound,and a combination of the two.X-ray barium enema was the gold standard.Results In this group of 84 children with suspected pediatric intussusception,63 cases were positive confirmed by X-ray barium enema and 21 cases were negative.Forty-eight cases were true positives and 16 cases were true negatives diagnosed by high frequency ultrasound;40 cases were true positives and 14 cases were true negatives diagnosed by low frequency ultrasound;57 cases were true positives and 18 cases were true negatives diagnosed by the combination of the two.The specificity and misdiagnosis rate of the combined diagnosis(85.71%,18/21;14.29%,3/21)had no significant difference with the high-frequency ultrasound(76.19%,16/21;23.81%,5/21)and low-frequency ultrasound(66.67%,14/21;33.33%,7/21),P>0.05.The sensitivity and accuracy of the combined diagnosis were 90.48%(57/63)and 89.29%(75/84),respectively,which were higher than those of high-frequency ultrasound alone(76.19%,48/63;76.19%,64/84)and low-frequency ultrasound alone(63.49%,40/63;64.29%,54/84),P<0.05.The missed diagnosis rate of the combined diagnosis was 9.52%(6/63),which was lower than 23.81%(5/21)of high-frequency ultrasound and 36.51%(23/63)of low-frequency ultrasound(P<0.05).The detection rate of concentric circle sign,mixed mass and intestinal wall edema of the combined diagnosis were higher than those of high-frequency and low-frequency ultrasound(all P<0.05).The detection rate of intussusception at different sites were high in the combined diagnosis of high-frequency ultrasound and low-frequency ultrasound,but there was no significant difference between the two groups(P>0.05).Conclusions High-frequency ultrasound combined with low-frequency ultrasound has a high accuracy in diagnosis of intussusception in children,which can provide effective scientific basis for clinical diagnosis and treatment,and is conducive to clinical application and promotion.