Fordham M Taylor, Rock Alex N, Bandarkar Anjum, Preciado Diego, Levy Michelle, Cohen Joanna, Safdar Nabile, Reilly Brian K
Department of Pediatric Otolaryngology, Children's National Health System, Washington, DC, U.S.A.
George Washington University School of Medicine, Washington, DC, U.S.A.
Laryngoscope. 2015 Dec;125(12):2799-804. doi: 10.1002/lary.25354. Epub 2015 May 6.
OBJECTIVES/HYPOTHESIS: Pediatric peritonsillar abscess (PTA) is a common infection, particularly in the adolescent population. Physical examination alone is not always sufficient to diagnose this pathology, and thus, computed tomography is often utilized as a diagnostic adjunct. With growing concern over radiation exposure in the pediatric population, we conducted a prospective study to investigate the use of ultrasonography in the detection of pediatric PTA.
Prospective single arm cohort study.
Pediatric patients examined in consultation for concern for PTA were prospectively enrolled in the study. Patients were managed based on clinical symptoms and presentation. Transcervical ultrasonography of the peritonsillar region was performed on all patients. Clinical outcomes were reviewed retrospectively and compared to ultrasound findings.
Forty-three patients (age range, 2-20 years) were enrolled in the study. The sensitivity and specificity of transcervical ultrasound when compared to clinical outcomes were 100% and 76.5%, respectively. The positive and negative predictive values were 52.9% and 100%, respectively. Fisher exact test showed a statistically significant association (P < .01) between negative ultrasonography and successful medical management, and multivariate regression analysis showed a strong correlation between ultrasound findings and presence/absence of purulence during surgical intervention (P = .01).
Transcervical ultrasonography is a useful tool in diagnosing pediatric PTA. This imaging modality not only avoids undue radiation exposure, but it also proves to be an excellent tool at identifying patients who will not need surgical intervention. To our knowledge, this is the first study to explore this technique for the diagnosis of pediatric PTA.
2b.
目的/假设：小儿扁桃体周围脓肿（PTA）是一种常见感染，在青少年人群中尤为常见。仅靠体格检查并不总是足以诊断这种病症，因此，计算机断层扫描常被用作辅助诊断手段。随着对儿科人群辐射暴露的日益关注，我们进行了一项前瞻性研究，以调查超声检查在小儿PTA检测中的应用。
前瞻性单臂队列研究。
因担心患有PTA前来咨询检查的儿科患者被前瞻性纳入本研究。患者根据临床症状和表现进行治疗。对所有患者进行扁桃体周围区域的经颈超声检查。对临床结果进行回顾性分析，并与超声检查结果进行比较。
43例患者（年龄范围2 - 20岁）被纳入本研究。与临床结果相比，经颈超声检查的敏感性和特异性分别为100%和76.5%。阳性预测值和阴性预测值分别为52.9%和100%。Fisher精确检验显示超声检查结果为阴性与成功的药物治疗之间存在统计学显著关联（P < 0.01），多因素回归分析显示超声检查结果与手术干预期间是否存在脓性分泌物之间存在强相关性（P = 0.01）。
经颈超声检查是诊断小儿PTA的一种有用工具。这种成像方式不仅避免了不必要的辐射暴露，而且还被证明是识别不需要手术干预患者的一种出色工具。据我们所知，这是第一项探索该技术用于诊断小儿PTA的研究。
2b。
