超声检查对肠套叠治疗复位后短期复发的诊断价值及其影像特征

The diagnostic value and imaging characteristics of ultrasonography for short-term recurrence after reduction of intussusception therapy

目的探讨超声检查对肠套叠治疗复位后短期复发的诊断价值及其影像特征。方法选取2022年1月至2023年1月赣州市妇幼保健院收治的86例肠套叠患儿作为研究对象,均予以灌肠治疗复位治疗并行超声检查。以病理诊断结果为金标准,分析超声检查对肠套叠治疗复位后短期复发的诊断结果及诊断价值;比较短期复发与未复发患儿临床特征、超声检查影像学特征及继发性病理因素。结果86例灌肠治疗复位的肠套叠患儿中,病理诊断短期复发11例,短期未复发75例,超声诊断短期复发16例,短期未复发70例,其中5例误诊为短期复发。超声检查诊断肠套叠短期复发的灵敏度为100.00%、特异度为93.33%、准确率为94.19%、阳性预测值为68.75%、阴性预测值为100.00%;超声检查与病理诊断的Kappa值为0.781,一致性较好。短期复发与未复发患儿年龄、性别及便血、发热、腹痛、腹泻及呕吐发生率比较差异无统计学意义;短期复发患儿体质量高于短期未复发患儿,差异有统计学意义(P<0.05)。短期复发患儿“套筒征”平均长度长于短期未复发患儿,差异有统计学意义(P<0.05);短期复发与未复发患儿“套叠鞘部”的平均厚度与“靶环征”的平均直径比较差异无统计学意义。短期复发与未复发患儿继发性病理因素比较差异有统计学意义(P<0.05)。结论超声检查对肠套叠短期复发的诊断价值较高,且与病理诊断的一致性较好,并能为灌肠治疗复位后短期复发的原因提供一定价值的影像学特征信息。

Objective To investigate the diagnostic value and imaging characteristics of ultrasonography for short-term recurrence after reduction of intussusception therapy.Methods A total of 86 children with intussusception treated in Ganzhou Maternal and Child Health Hospital from January 2022 to January 2023 were selected as the study subjects,and all of them were treated with enema and reset and ultrasound examination were performed.The pathological diagnosis results were used as the gold standard to analyze the results and diagnostic value of ultrasonography for short-term recurrence after reduction of intussusception;the clinical features,ultrasound imaging characteristics and secondary pathological factors were compared between children with short-term recurrence and those without recurrence.Results Among 86 children with reduced intussusception treated by enema,11 cases had short-term recurrence,75 cases had not short-term recurrence by pathological diagnosis;16 cases had short-term recurrence,70 cases had not short-term recurrence,5 cases were misdiagnosed as short-term recurrence by ultrasound diagnosis.The diagnostic sensitivity,specificity,accuracy,positive predictive value of ultrasonography in the diagnosis of short-term recurrence of intussusception were 100.00%,93.33%,94.19%,68.75%and 100.00%,respectively;the Kappa value of ultrasonic examination and pathological diagnosis was 0.781,which was in good agreement.There was no significant difference in age,gender and the incidence of hematochesia,fever,abdominal pain,diarrhea and vomiting between children with short-term recurrence and children without short-term recurrence;the body mass of children with short-term recurrence was higher than that of children without short-term recurrence,and the difference was statistically significant(P<0.05).The average length of"sleeve sign"in children with short-term recurrence was longer than children without short-term recurrence,and the difference was statistically significant(P<0.05);there was no significant difference between the mean thickness of intussusception sheath and the mean diameter of target ring sign in children with short-term recurrence and without short-term recurrence.There were significant differences in the secondary pathological factors between the children with short-term recurrence and children without recurrence(P<0.05).Conclusion Ultrasonography has a high diagnostic value for short-term recurrence of intussusception,and is in good agreement with pathological diagnosis,and can provide valuable imaging characteristics information for the causes of short-term recurrence after enema treatment.