Xu Qiuchen, Liu Min, Wu Qiumei, Ling Wen, Guo Shan
Department of Medical Ultrasonics, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Front Pediatr. 2022 Apr 14;10:775378. doi: 10.3389/fped.2022.775378. eCollection 2022.
To determine the clinical value of high-frequency ultrasonography (US) in the evaluation and diagnosis of pancreaticobiliary maljunction (PBM) among children.
The clinical subjects consisted of 31 pediatric patients who were diagnosed with PBM from January 2015 to May 2021 in Fujian Provincial Maternity and Children's Hospital. The primary outcomes included diagnosis accuracy, imaging characteristics of each type of PBM based on JSPBM, time length of operation, and cost of service. Secondary outcomes were the serum amylase and bilirubin levels.
The diagnostic accuracy of US was 90.3% and comparable to the other imaging methods-MRCP (82.6%), IOC (79.2%), and ERCP (100%), respectively. The time length of operation and direct cost were significantly lower than other imaging pathways. Stenotic type (A) is associated with a high internal diameter of CBD, and dilated channel type (C) presents increased internal diameter and length of CC as well as internal diameter of PD. There were higher levels of the serum bilirubin seen in type A and of serum amylase in type C compared with others.
High-frequency US is a safe, cost-effective, and non-invasive imaging tool for the diagnosis and evaluation of PBM in pediatrics.
确定高频超声（US）在评估和诊断儿童胰胆管合流异常（PBM）中的临床价值。
临床研究对象为2015年1月至2021年5月在福建省妇幼保健院被诊断为PBM的31例儿科患者。主要结局包括诊断准确性、基于日本胰胆管合流异常研究学会（JSPBM）的各类型PBM的影像学特征、手术时长和服务费用。次要结局为血清淀粉酶和胆红素水平。
US的诊断准确性为90.3%，分别与其他成像方法——磁共振胰胆管造影（MRCP，82.6%）、术中胆道造影（IOC，79.2%）和内镜逆行胰胆管造影（ERCP，100%）相当。手术时长和直接费用显著低于其他成像途径。狭窄型（A）与胆总管内径增大有关，扩张通道型（C）表现为胆囊管内径和长度增加以及胰管内径增加。与其他类型相比，A 型患者血清胆红素水平较高，C型患者血清淀粉酶水平较高。
高频US是诊断和评估儿科PBM的一种安全、经济高效且无创的成像工具。
