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腹部超声在儿童急腹症诊断中的临床价值。

Clinical Value of Abdominal Ultrasonography in the Diagnosis of Acute Abdomen in Children.

机构信息

Department of Ultrasound, Wuxi Children's Hospital, Wuxi, Jiangsu 214023, China.

Department of Pediatric Intensive Care Medicine, Wuxi Children's Hospital, Wuxi, Jiangsu 214023, China.

出版信息

Contrast Media Mol Imaging. 2022 Jun 23;2022:2681543. doi: 10.1155/2022/2681543. eCollection 2022.

Abstract

In order to study the practical application value of abdominal ultrasonography in the diagnosis and treatment of acute abdomen in children, this study uses the method of collecting clinical actual cases and scientific analysis to estimate the clinical diagnostic value of high-frequency ultrasound and low-frequency ultrasound. In order to further clarify its curative effect and treatment advantages, a retrospective analysis of medical records was conducted, and 95 children with acute abdominal pain and suspected appendicitis who were admitted to a hospital from September 2021 to November 2021 were reviewed. ATIL HD15000 color Doppler ultrasound was used for diagnosis. The results are as follows: the sensitivity, specificity, positive predictive value, and negative predictive value of low-frequency probe in the diagnosis of intussusception in children were 83.61%, 73.33%, 92.73%, and 52.38%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of mesenteric lymphadenitis were 80.00%, 81.97%, 52.17%, and 94.34%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of high-frequency probe in the diagnosis of intussusception in children were 93.44%, 80.00%, 95.00%, and 75.00%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of mesenteric lymphadenitis were 93.33%, 95.08%, 82.35%, and 98.31%, respectively. Among the children with appendicitis confirmed by operation and pathology, 69 cases were detected by high-frequency ultrasound and 4 cases were missed (including 3 cases of acute simple appendicitis and 1 case of perforated appendicitis). The false negative was 4%, there was no false positive, and the sensitivity, specificity and accuracy were 95%, 100%, and 96%. In the same cases, 28 cases were detected by low-frequency ultrasound, 45 cases were missed, the false negative was 61%, and there was no false positive. The sensitivity, specificity, and accuracy were 39%, 100%, and 53%. The sensitivity, accuracy, and false negative of high-frequency ultrasound in the diagnosis of acute appendicitis were significantly higher than that of low-frequency ultrasound. This study shows that ultrasound has high accuracy, sensitivity, and specificity in the diagnosis of acute appendicitis. Low-frequency ultrasound can show the whole picture of the disease and the situation in the abdominal cavity, which can better guide the clinical treatment. Color Doppler hemodynamics is a useful supplement to two-dimensional ultrasound, and ultrasound also plays a positive role in the differential diagnosis of acute appendicitis in children.

摘要

为了研究腹部超声在儿童急腹症诊断和治疗中的实际应用价值,本研究采用收集临床实际病例和科学分析的方法,评估高频超声和低频超声的临床诊断价值。为了进一步明确其疗效和治疗优势,对 2021 年 9 月至 2021 年 11 月期间因急性腹痛和疑似阑尾炎而入院的 95 例儿童进行了病历回顾性分析。采用 ATIL HD15000 彩色多普勒超声进行诊断。结果如下:低频探头诊断小儿肠套叠的灵敏度、特异度、阳性预测值和阴性预测值分别为 83.61%、73.33%、92.73%和 52.38%。诊断肠系膜淋巴结炎的灵敏度、特异度、阳性预测值和阴性预测值分别为 80.00%、81.97%、52.17%和 94.34%。高频探头诊断小儿肠套叠的灵敏度、特异度、阳性预测值和阴性预测值分别为 93.44%、80.00%、95.00%和 75.00%。诊断肠系膜淋巴结炎的灵敏度、特异度、阳性预测值和阴性预测值分别为 93.33%、95.08%、82.35%和 98.31%。经手术和病理证实的阑尾炎患儿中,高频超声检出 69 例,漏诊 4 例(其中急性单纯性阑尾炎 3 例,穿孔性阑尾炎 1 例),漏诊率为 4%,无假阳性,灵敏度、特异度和准确率分别为 95%、100%和 96%。在相同病例中,低频超声检出 28 例,漏诊 45 例,漏诊率为 61%,无假阳性,灵敏度、特异度和准确率分别为 39%、100%和 53%。高频超声诊断急性阑尾炎的灵敏度、准确率和漏诊率明显高于低频超声。本研究表明,超声在诊断急性阑尾炎方面具有较高的准确性、灵敏度和特异性。低频超声可以显示疾病的全貌和腹腔内情况,能更好地指导临床治疗。彩色多普勒血流动力学是二维超声的有益补充,超声在儿童急性阑尾炎的鉴别诊断中也发挥着积极作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bcb1/9246588/26c979ec7684/CMMI2022-2681543.001.jpg

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