钡剂灌肠在先天性巨结肠症诊断中的再评价。

Barium Enema Revisited in the Workup for the Diagnosis of Hirschsprung's Disease.

机构信息

Department of Surgery.

Department of Pathology, Botucatu Medical School, Unesp - São Paulo State University, Botucatu.

出版信息

J Pediatr Gastroenterol Nutr. 2019 Apr;68(4):e62-e66. doi: 10.1097/MPG.0000000000002242.

DOI:10.1097/MPG.0000000000002242

PMID:30628984

Abstract

OBJECTIVE

To analyse the diagnostic capacity of barium enema (BE) in the diagnostic investigation for Hirschsprung's disease (HD) was analyzed for transition zone (TZ) identification and rectosigmoid index (RSI) ≤1.0 determination.

PATIENTS AND METHODS

BE images were analyzed retrospectively by 2 examiners and the results were compared with the histopathology of rectal biopsies.

RESULTS

TZ identification and RSI ≤1.0 were assessed separately and combined in 43 patients. Twelve (27.9%) patients had the diagnosis of HD based on rectal biopsies. TZ identification presented better diagnostic capacity for the 2 examiners than RSI ≤1.0. However, interexaminer agreement was higher for RSI ≤1.0 than for TZ identification. The combination of TZ identification and RSI ≤1.0 increased the sensitivity (83.3%-92.3%) and the negative predictive value (90.4%-92.3%).

CONCLUSION

Therefore, the high diagnostic sensitivity of TZ identification combined to RSI ≤1.0 reinforces the usefulness of these BE parameters in the screening for Hirschsprung's disease.

摘要

目的

分析钡灌肠（BE）在先天性巨结肠（HD）诊断中的诊断能力，用于分析移行区（TZ）的识别和直肠乙状结肠指数（RSI）≤1.0 的确定。

患者和方法

通过 2 名检查者对 BE 图像进行回顾性分析，并将结果与直肠活检的组织病理学进行比较。

结果

在 43 名患者中，单独评估了 TZ 识别和 RSI≤1.0，并将其组合。12 名（27.9%）患者根据直肠活检诊断为 HD。与 RSI≤1.0 相比，TZ 识别对 2 名检查者的诊断能力更好。然而，RSI≤1.0 的检查者间一致性高于 TZ 识别。TZ 识别与 RSI≤1.0 的组合提高了敏感性（83.3%-92.3%）和阴性预测值（90.4%-92.3%）。