CT平扫与经腹壁彩超诊断小儿肠套叠的价值比较

Comparison of the value of CT scan and transabdominal wall ultrasound in the diagnosis of pediatric intussusception

目的对比CT平扫与经腹壁彩超诊断小儿肠套叠的价值。方法选取2021年5月至2022年11月在徐州星晨妇儿医院放射科就诊的48例疑似肠套叠患儿,所有患儿均行CT平扫与经腹壁彩超检查,以手术病理检查为金标准,分析两种诊断方法的影像学特征,并比较其在小儿肠套叠中的诊断效能。结果手术病理诊断为肠套叠40例,非肠套叠8例。经CT平扫诊断为肠套叠37例,非肠套叠3例;经腹壁彩超诊断为肠套叠38例,非肠套叠2例。CT平扫和经腹壁彩超诊断肠套叠的灵敏度、特异度、准确度、阳性预测值、阴性预测值比较,差异无统计学意义(P>0.05)。经CT平扫确诊为肠套叠的37例患儿中,影像显示有套筒征、腊肠征,肠系膜出现条纹状的增粗改变。经腹壁彩超确诊为肠套叠的38例患儿中,影像显示肠套叠区域边界较为清晰,血流信号Ⅰ~Ⅱ级者9例(23.68%),Ⅲ~Ⅳ级者29例(76.32%)。CT平扫检查前准备耗时以及检查中耗时均短于经腹壁彩超(P<0.05)。结论在小儿肠套叠的诊断中,CT平扫与经腹壁彩超效能相当,但CT平扫诊断耗时相对较少,操作简便。

Objective To compare the value of CT scan and transabdominal wall ultrasound in the diagnosis of pediatric intussusception.Methods A total of 48 children suspected with intussusception who were admitted to the Department of Radiology of Xuzhou Xingchen Women and Children’s Hospital from May 2021 to November 2022 were selected.All children were examined by CT scan and transabdominal wall ultrasound.The imaging features of the two methods were analyzed based on the gold standard of surgical pathology,and their diagnostic efficacy in children with intussusception was compared.Results Surgical pathology was diagnosed as intussusception in 40 cases and nonintussusception in 8 cases.There were 37 cases of intussusception and 3 cases of non-intussusception diagnosed by CT scan,and 38 cases of intussusception and 2 cases of non-intussusception diagnosed by abdominal wall ultrasound.The differences in sensitivity,specificity,accuracy,positive predictive value,and negative predictive value between CT scan and transabdominal wall ultrasound for the diagnosis of intussusception were not statistically significant(P>0.05).Of the 37 children diagnosed with intussusception by CT scan,the images showed a sleeve sign,a salami sign and striated thickening of the mesentery.Of the 38 children with intussusception confirmed by abdominal wall ultrasound,the image showed that the boundary of intussusception was relatively clear,with blood flow signals of gradeⅠtoⅡin 9 cases(23.68%)and gradeⅢtoⅣin 29 cases(76.32%).The time of preparation before and during CT scan was shorter than that of transabdominal wall ultrasound(P<0.05).Conclusion The efficacy of CT scan and transabdominal wall ultrasound in the diagnosis of pediatric intussusception is comparable,but CT scan is relatively less time-consuming and easier to perform.