胃肠道超声造影在儿童消化性溃疡诊断和治疗中的应用。

Gastrointestinal contrast-enhanced ultrasonography for diagnosis and treatment of peptic ulcer in children.

机构信息

Department of Ultrasound, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.

出版信息

World J Gastroenterol. 2024 Feb 21;30(7):705-713. doi: 10.3748/wjg.v30.i7.705.

DOI:10.3748/wjg.v30.i7.705

PMID:38515948

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10950618/

Abstract

BACKGROUND

The detection rate of peptic ulcer in children is improving, with development of diagnostic procedures. Gastroscopy is the gold standard for the diagnosis of peptic ulcer, but it is an invasive procedure. Gastrointestinal contrast-enhanced ultrasonography (CEUS) has the advantages of being painless, noninvasive, nonradioactive, easy to use, and safe.

AIM

To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children.

METHODS

We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022. All children were examined by routine ultrasound, gastrointestinal CEUS, and gastroscopy. The pathological results of gastroscopy were taken as the gold standard. Routine ultrasonography was performed before gastrointestinal CEUS. Conventional ultrasound showed the thickness of the gastroduodenal wall, gastric peristalsis, and the adjacent organs and tissues around the abdominal cavity. Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall; the size, location and shape of the ulcer; gastric peristalsis; and adjacent organs and tissues around the abdominal cavity. The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS. All children received informed consent from their guardians for CEUS. This study was reviewed and approved by the hospital medical ethics committee.

RESULTS

Among the 43 children, 17 (15 male, 2 female) were diagnosed with peptic ulcer by gastroscopy. There were 26 children with nonpeptic ulcer. There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound. The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1% (34/43), which was significantly different from that of gastroscopy ( = 0.033). It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low. Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS. The diagnostic coincidence rate of peptic ulcer in children was 95.3% (41/43). There was no significant difference between CEUS and gastroscopy ( = 0.655). It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high.

CONCLUSION

Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children, and can be used as a preliminary examination method.

摘要

背景

随着诊断技术的发展，儿童消化性溃疡的检出率不断提高。胃镜检查是诊断消化性溃疡的金标准，但它是一种有创性的检查。胃肠超声造影（CEUS）具有无痛、无创、无放射性、操作简便、安全等优点。

目的

探讨 CEUS 对儿童消化性溃疡的诊断及治疗价值。

方法

选取 2021 年 1 月至 2022 年 6 月在我院就诊的 43 例有消化道症状的患儿，均行常规超声、胃肠 CEUS 和胃镜检查。以胃镜病理结果为金标准，胃肠 CEUS 前先行常规超声检查。常规超声观察胃十二指肠壁厚度、胃蠕动及腹腔毗邻的脏器组织。胃肠 CEUS 记录胃十二指肠壁厚度、溃疡大小、位置、形态、胃蠕动及腹腔毗邻的脏器组织。比较常规超声和胃肠超声的检查结果与胃镜的诊断符合率。所有患儿均经监护人知情同意后行 CEUS 检查。本研究经医院医学伦理委员会审查批准。

结果

43 例患儿中，胃镜检查诊断为消化性溃疡 17 例（男 15 例，女 2 例），非消化性溃疡 26 例。常规超声诊断消化性溃疡 8 例，非消化性溃疡 35 例。常规超声诊断儿童消化性溃疡的符合率为 79.1%（34/43），与胃镜比较差异有统计学意义（ = 0.033），提示胃肠超声造影与胃镜的符合率较低。CEUS 诊断消化性溃疡 15 例，非消化性溃疡 28 例。CEUS 诊断儿童消化性溃疡的符合率为 95.3%（41/43），与胃镜比较差异无统计学意义（ = 0.655），提示胃肠超声造影与胃镜的符合率较高。