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儿童大肠息肉的超声诊断:诊断准确性及多因素联合评估

Sonographic diagnosis of colorectal polyps in children: Diagnostic accuracy and multi-factor combination evaluation.

作者信息

Qu Ni-Na, Liu Rui-Hua, Shi Lei, Cao Xiao-Li, Yang Yong-Jun, Li Jie

机构信息

Department of Ultrasound, Affiliated Yantai Yuhuangding Hospital of Qingdao University.

Department of Ultrasound, Qilu Hospital of Shandong University.

出版信息

Medicine (Baltimore). 2018 Sep;97(39):e12562. doi: 10.1097/MD.0000000000012562.

Abstract

This study was established to evaluate the diagnostic value of ultrasonography in screening colorectal polyps in children and to discuss the necessity of colonic preparation before an ultrasonic examination.In this study, 288 children with colorectal polyps managed at our hospital between January 2007 and December 2016 were retrospectively reviewed. All patients were examined before and after basic colon preparation. The colorectal polyps were confirmed by colonoscopy/laparotomy and histopathology. Among all 288 patients, solitary polyps were identified in 278 patients (96.52%), and multiple polyps were identified in 10 patients (43 polyps) (3.48%) by colonoscopy/laparotomy and histopathology.By ultrasonic examination, 264 cases (264/278) were detected as solitary polyp and 9 cases (9/10) as multiple polyps (31 polyps). In 278 solitary polyps, 180 (64.74%) were detected by ultrasonic examination without a colon preparation. Following glycerine enema (10-20 mL) treatment, 264 (94.96%) cases were detected by ultrasonic examination. The sensitivity and specificity of ultrasonography with glycerine enema for the detection of colorectal polyps were 94.96% and 100%, respectively. Colon preparation significantly increased the proportion of polyps identified by ultrasonography (P < .0001), as well as the diagnostic rate of polyps in rectum, sigmoid colon and descending colon (P < .05).Ultrasonography can be the primary diagnostic method for screening colorectal polyps in children on the strength of its safety, validity, and accuracy. Basic colon preparation with glycerine enema is recommended for children, which enable the detection of intraluminal lesions before ultrasonic examination.

摘要

本研究旨在评估超声检查在儿童结直肠息肉筛查中的诊断价值,并探讨超声检查前进行肠道准备的必要性。本研究回顾性分析了2007年1月至2016年12月在我院接受治疗的288例结直肠息肉患儿。所有患者在进行基础肠道准备前后均接受检查。结直肠息肉通过结肠镜检查/剖腹手术及组织病理学确诊。在全部288例患者中,通过结肠镜检查/剖腹手术及组织病理学发现,278例患者(96.52%)为单发息肉,10例患者(43枚息肉)(3.48%)为多发息肉。通过超声检查,264例(264/278)被检测为单发息肉,9例(9/10)被检测为多发息肉(31枚息肉)。在278例单发息肉中,180例(64.74%)在未进行肠道准备的情况下通过超声检查被发现。经甘油灌肠(10 - 20毫升)治疗后,264例(94.96%)通过超声检查被发现。甘油灌肠后超声检查对结直肠息肉检测的敏感性和特异性分别为94.96%和100%。肠道准备显著提高了超声检查发现息肉的比例(P < 0.0001),以及直肠、乙状结肠和降结肠息肉的诊断率(P < 0.05)。基于其安全性、有效性和准确性,超声检查可作为儿童结直肠息肉筛查的主要诊断方法。建议对儿童采用甘油灌肠进行基础肠道准备,以便在超声检查前发现腔内病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4939/6181612/d3f63f8f1f6b/medi-97-e12562-g002.jpg

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