彩色多普勒超声诊断鉴别小儿急性阑尾炎与肠系膜淋巴结炎的准确率分析

Analysis of the accuracy of color Doppler ultrasound diagnosis in distinguishing acute appendicitis and mesenteric lymphadenitis inchildren

目的分析彩色多普勒超声诊断鉴别小儿急性阑尾炎与肠系膜淋巴炎的准确率。方法选取我院门诊外科2020年3月至2023年3月收治的腹痛症疑似急性阑尾炎或肠系膜淋巴结炎患儿76例,给予彩色多普勒超声检查和病理组织学检查。以病理组织学检查结果为金标准,评估彩色多普勒超声鉴别诊断小儿急性阑尾炎、肠系膜淋巴结炎的准确率及不同疾病声像图特征。结果76例患儿中,病理组织学检查出急性阑尾炎47例,肠系膜淋巴结炎29例,彩色多普勒超声检查出急性阑尾炎46例,肠系膜淋巴结炎30例,彩色多普勒超声诊断鉴别小儿急性阑尾炎的灵敏度为97.9%(47/48)、特异度100%(29/29)、准确率97.9%(46/47)、阳性预测值100%(47/47)、阴性预测值96.7%(29/30)。彩色多普勒超声诊断鉴别小儿肠系膜淋巴结炎的灵敏度为100%(29/29)、特异度97.9%(47/48)、准确度98.7%(75/76)、阳性预测值96.7%(29/30)、阴性预测值100%(47/47)。小儿急性阑尾炎与肠系膜淋巴结炎的声像图特征差异明显,其中小儿急性阑尾炎患儿的阑尾肿大,呈不规则低回声,血流信号丰富,血流性状不规则;肠系膜淋巴结炎患儿的淋巴增大,呈均匀的低回声,血流信号丰富,血流性状规则。结论彩色多普勒超声诊断鉴别小儿急性阑尾炎与肠系膜淋巴炎的准确率高,值得临床推广应用。

Objective To analyze the accuracy of color Doppler ultrasound in diagnosing and distinguishing acute appendicitis and mesenteric lymphadenitis in children.Methods Seventy-six children with abdominal pain suspected of acute appendicitis or mesenteric lymphadenitis admitted to our pediatric department from March 2020 to March 2023 were selected for color Doppler ultrasound examination and histopathological examination.The accuracy of color Doppler ultrasound in the differential diagnosis of acute appendicitis and mesenteric lymphadenitis in children,as well as the sonographic characteristics of different diseases,were evaluated based on the results of histopathological examination as the gold standard.Results Among the 76 pediatric patients,47 cases were diagnosed with acute appendicitis by histopathology,29 cases with mesenteric lymphadenitis,46 cases with acute appendicitis by color Doppler ultrasound,and 30 cases with mesenteric lymphadenitis.The sensitivity,specificity,accuracy,positive predictive value,and negative predictivevalue of color Doppler ultrasound in distinguishing acute appendicitis in children were 97.9%(47/48),100%(29/29),97.9%(46/47),100%(47/47),and 96.7%(29/30),respectively.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of color Doppler ultrasound in the diagnosis and differentiation of pediatric mesenteric lymphadenitis were 100%(29/29),97.9%(47/48),98.7%(75/76),96.7%(29/30),and 100%(47/47),respectively.There is a significant difference in the ultrasound characteristics between acute appendicitis and mesenteric lymphadenitis in children.Among them,the appendix in children with acute appendicitis is enlarged,with irregular low echoes,rich blood flow signals,and irregular blood flow characteristics.Children with mesenteric lymphadenitis have enlarged lymph nodes with uniform hypoechogenicity,rich blood flow signals,and regular blood flow characteristics.Conclusion Color Doppler ultrasound has a high accuracy in diagnosing and distinguishing acute appendicitis and mesenteric lymphadenitis in children,and is worthy of clinical promotion and application.