Lewartowska-Nyga Dorota, Nyga Kamil, Skotnicka-Klonowicz Grażyna
Oddział Kardiologii i Reumatologii dla Dzieci, II Katedra Pediatrii UM w Łodzi, Ośrodek Pediatryczny im. M. Konopnickiej, Centralny Szpital Kliniczny UM w Łodzi.
Centrum Medycyny Rodzinnej i Społeczności Lokalnych UM w Łodzi.
Dev Period Med. 2017;21(1):51-59. doi: 10.34763/devperiodmed.20172101.5159.
The aim of the study was to determine whether Infrascanner screening is a test which would facilitate excluding acute intracranial bleeding in children after minor head injury and thus make it possible to limit indications for computed tomography in those children.
The study enrolled 155 children aged 2-18 years after a minor or moderate head injury. The children were assessed using the Glasgow Coma Scale, examined by Infrascanner screening. Those who had relvant indications also had head computed tomography.
A negative Infrascanner screening result (no intracranial bleeding) was noted in 151 children. The Infrascanner result was positive in 4 children. Head computed tomography was performed in 28 of the 155 children. The conformity of the Infrascanner result with the computed tomography image was found in 26 children: no evidence of intracranial bleeding in 24 children and confirmation of intracranial haematoma in 2 children. The sensitivity of the screening was 66.67% and its specificity 98.68%. The positive and negative predictive values of the screening were 50% and 99.34%, respectively. The reliability of the test results was 98.06%.
The Infrascanner seems to be a useful device in diagnosing children after minor head injury in the emergency department and its portability makes it possible to use it in practically all settings. Introducing the device into management standards in children after minor head injury might facilitate selecting those after minor head injury who are not at risk of intracranial bleeding and contribute to a reduction in the number of imaging investigations being performed and decrease the number of hospitalisations.
本研究旨在确定红外扫描仪筛查是否有助于排除小儿轻度头部外伤后急性颅内出血,从而限制这些患儿进行计算机断层扫描的指征。
本研究纳入了155名2至18岁的轻度或中度头部外伤患儿。使用格拉斯哥昏迷量表对患儿进行评估,并通过红外扫描仪筛查进行检查。有相关指征的患儿也进行了头部计算机断层扫描。
151名患儿的红外扫描仪筛查结果为阴性(无颅内出血)。4名患儿的红外扫描仪结果为阳性。155名患儿中有28名进行了头部计算机断层扫描。在26名患儿中发现红外扫描仪结果与计算机断层扫描图像相符:24名患儿无颅内出血证据,2名患儿证实有颅内血肿。筛查的敏感性为66.67%,特异性为98.68%。筛查的阳性预测值和阴性预测值分别为50%和99.34%。检测结果的可靠性为98.06%。
红外扫描仪似乎是急诊科诊断小儿轻度头部外伤的有用设备,其便携性使其几乎可以在所有环境中使用。将该设备引入小儿轻度头部外伤的管理标准中,可能有助于筛选出无颅内出血风险的轻度头部外伤患儿,减少影像学检查的次数,并减少住院人数。