Hirsch W, Kedar R, Preiss U
University Hospital Halle, D-06097 Halle/S., Germany.
Pediatr Radiol. 1996;26(3):232-5. doi: 10.1007/BF01405307.
Eighty-four high risk children were examined for suspected gastroesophageal reflux comparing 24-h esophageal pH measurements with ultrasound (US) scans with and without the use of color Doppler (CD). In 83.3 % of the patients there was unequivocal agreement (reflux or no reflux) among all three techniques; 60.7 % of the children showed reflux by pH-metry as compared to 51.2 % by B-mode US and 59.5 % by CD US. In 87 % of patients there was agreement between pH-metry and B-mode US as compared to 94 % between pH-metry and CD US. The sensitivity of reflux detection increased from 84.4 % to 98 % when CD was added to B-mode US. This improvement was thought to be due to the higher sensitivity of CD for rapid and small quantities of reflux. The small number of discrepancies between pH-metry and CD US is probably due to the inability of the former to detect neutral reflux of contents or short duration (< 30 s), while CD US may miss some cases of acid reflux due to the short time of the examination (10 min). The addition of CD increases the sensitivity of US for detecting reflux. This rapid, easy and reliable method can be used to screen high risk populations when reflux is thought to be the cause of respiratory symptoms.
对84名疑似胃食管反流的高危儿童进行了检查，比较了24小时食管pH测量值与超声（US）扫描结果，超声扫描采用了彩色多普勒（CD）和未采用彩色多普勒两种方式。在83.3%的患者中，所有三种技术在反流与否的判断上完全一致；60.7%的儿童经pH测定显示有反流，而B型超声显示反流的比例为51.2%，彩色多普勒超声显示反流的比例为59.5%。87%的患者pH测定与B型超声结果一致，而pH测定与彩色多普勒超声结果一致的比例为94%。当在B型超声中加入彩色多普勒时，反流检测的敏感性从84.4%提高到了98%。这种改善被认为是由于彩色多普勒对快速少量反流具有更高的敏感性。pH测定与彩色多普勒超声之间的差异较少，可能是因为前者无法检测到内容物的中性反流或短时间（<30秒）的反流，而彩色多普勒超声可能由于检查时间短（10分钟）而漏诊一些酸反流病例。加入彩色多普勒提高了超声检测反流的敏感性。这种快速、简便且可靠的方法可用于筛查认为反流是呼吸道症状病因的高危人群。
