高回声环对新生儿环状胰腺的诊断价值  

Diagnostic value of hyperechogenic band in neonatal annular pancreas

作　　者：杨博洋 周路遥[2] 钟微[3] 何秋明[3] 王哲[3] 方倩 戴常平[1] 王红英 Yang Boyang;Zhou Luyao;Zhong Wei;He Qiuming;Wang Zhe;Fang Qian;Dai Changping;Wang Hongying(Department of Ultrasonography,Guangzhou Municipal Women and Children’s Medical Center,Guangzhou Medical University,Guangzhou,Guangdong 510623,China;Department of Ultrasonography,First Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong 510080,China;Department of Neonatal Surgery and Neonatal Surgical Intensive Care Unit,Guangzhou Municipal Women and Children’s Medical Center,Guangzhou Medical University,Guangzhou,Guangdong 510623,China)

机构地区：[1]广州医科大学广州市妇女儿童医疗中心超声科,广东广州510623 [2]中山大学附属第一医院超声科 [3]广州医科大学广州市妇女儿童医疗中心新生儿外科和新生儿外科重症监护室,广东广州510623

出　　处：《广州医科大学学报》2020年第4期29-32,共4页Academic Journal of Guangzhou Medical University

基　　金：广东省自然科学基金项目(2019A1515010971);广州市儿科研究所/广州市妇女儿童医疗中心(IP-2018-015)。

摘　　要：目的:分析狭窄的十二指肠降段周围的高回声环对新生儿环状胰腺的诊断价值。方法:经上消化道超声生理盐水造影诊断为十二指肠梗阻的新生儿共78例。前瞻性分析所有患儿上消化道超声造影的图像特征,并记录手术结果。结果:手术确诊为环状胰腺29例,十二指肠闭锁3例,十二指肠隔膜26例,肠旋转不良20例。高回声环诊断环状胰腺的敏感性,特异性,阳性预测值和阴性预测值分别为79.3%(23/29)、93.8%(46/49)、88.4%(23/26)、88.4%(46/52)。有2例新生儿经超声诊断为环状胰腺合并十二指肠隔膜,1例新生儿经超声诊断为环状胰腺合并肠旋转不良,并经手术证实。经手术证实有2例新生儿为环状胰腺合并Meckel憩室,而Meckel憩室并未经术前超声诊断。结论:应用狭窄的十二指肠降段周围的高回声环可以诊断大部分新生儿环状胰腺。Objective:To determine the diagnostic value of the hyperechogenic band around the descending segment of narrowed duodenum in neonatal annular pancreas.Methods:Seventy-eight neonates diagnosed with duodenal obstruction by upper gastrointestinal saline-contrast ultrasonography were included in the study.The image features of upper gastrointestinal ultrasonography were prospectively analyzed,and the surgical results were recorded.Results:According to surgical diagnosis,there were 29 cases of annular pancreas,3 of duodenal atresia,26 of duodenal septum,and 20 of malrotation.The sensitivity,specificity,positive predictive value and negative predictive value of the hyperechogenic band for diagnosing annular pancreas were 79.3%(23/29),93.8%(46/49),88.4%(23/26),and 88.4%(46/52),respectively.Two neonates were diagnosed with annular pancreas and duodenal septum,and one was diagnosed with annular pancreas and malrotation,which were confirmed by surgery.Two neonates were confirmed to have annular pancreas and Meckel diverticulum by surgery,but the latter was not identified by preoperative ultrasonography.Conclusion:The use of hyperechogenic band around the descending segment of narrowed duodenum may identify neonatal annular pancreas in most of cases.

关 键 词：超声检查 新生儿 环状胰腺 

分 类 号：R445.1[医药卫生—影像医学与核医学]