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高频超声对儿童 Meckel 憩室出血的诊断准确性。

Diagnostic accuracy of high-frequency ultrasound in bleeding Meckel diverticulum in children.

机构信息

Department of Ultrasound, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, No.56 Nan Li Shi Road, Xi Cheng District, Beijing, 100045, China.

出版信息

Pediatr Radiol. 2020 May;50(6):833-839. doi: 10.1007/s00247-020-04628-x. Epub 2020 Feb 20.

Abstract

BACKGROUND

Meckel diverticulum is one of the most important causes of small bowel bleeding in children. Reports suggest that ultrasonography can be used as an alternative examination for children with negative radionuclide scanning results or children with atypical clinical manifestations.

OBJECTIVE

To evaluate the diagnostic accuracy of high-frequency ultrasound in children with bleeding Meckel diverticulum.

MATERIALS AND METHODS

We collected the data of children who were admitted to our hospital for the main symptom of bloody stool from February 2006 to December 2017. Ultrasonography was performed in all children. The final diagnosis was confirmed by pathological analysis or clinical follow-up observation. We evaluated the diagnostic performance of ultrasonography according to the final diagnosis.

RESULTS

A total of 784 eligible children were enrolled in the study. Presenting symptoms or findings included black and red stool in 528 (67.3%), bright red stool in 51 (6.5%) and obscure or occult bloody stool in 205 (26.1%). Anemia was diagnosed in 489 (62.4%). Ultrasonography diagnosed Meckel diverticulum with a sensitivity of 93.6% (95% confidence interval [CI] 91.0-95.6%) and a specificity of 98.1% (95% CI 95.9-99.3%).

CONCLUSION

High-frequency ultrasound diagnosis of Meckel diverticulum in children has high sensitivity and specificity.

摘要

背景

梅克尔憩室是儿童小肠出血的最重要原因之一。有报道称,超声检查可作为核素扫描结果阴性或临床表现不典型的儿童的替代检查方法。

目的

评估高频超声诊断儿童出血性梅克尔憩室的准确性。

材料和方法

我们收集了 2006 年 2 月至 2017 年 12 月期间因主要症状为血便而入院的儿童的数据。所有儿童均进行了超声检查。最终诊断通过病理分析或临床随访观察确定。根据最终诊断评估超声检查的诊断性能。

结果

共有 784 名符合条件的儿童入组本研究。主要症状或发现包括 528 例(67.3%)黑便或红便、51 例(6.5%)鲜红便和 205 例(26.1%)暗或隐血便。489 例(62.4%)诊断为贫血。超声诊断梅克尔憩室的灵敏度为 93.6%(95%置信区间[CI]91.0-95.6%),特异性为 98.1%(95% CI 95.9-99.3%)。

结论

高频超声诊断儿童梅克尔憩室具有较高的灵敏度和特异性。

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