儿童阑尾炎的超声特征与病理分型分析  

Ultrasound characteristics and pathological classifications of appendicitis in children

作　　者：黄兰 何琛波 罗元臣 张英 HUANG Lan;HE Chenbo;LUO Yuanchen;ZHANG Ying(Department of Ultrasound,the Fourth People's Hospital of Chenzhou,Chenzhou 423000,China;Center of Imaging Medicine,the First People's Hospital of Chenzhou,Chenzhou 423000,China;Department of Ultrasound,the First Hospital of Changsha,Changsha 410006,China)

机构地区：[1]郴州市第四人民医院超声科,湖南郴州423000 [2]郴州市第一人民医院影像医学中心,湖南郴州423000 [3]长沙市第一医院超声科,湖南长沙410006

出　　处：《中国医学物理学杂志》2023年第1期83-86,共4页Chinese Journal of Medical Physics

基　　金：长沙市科技计划项目(K1403066-31)。

摘　　要：目的:探讨儿童阑尾炎的超声特征与病理分型的关系。方法:回顾性分析72例阑尾炎患儿的临床资料,均接受超声检查,顺利完成急性阑尾炎切除手术且经病理证实。以病理检查为金标准,分析超声评估儿童阑尾炎病理分型的Kappa一致性;比较不同病理分期儿童阑尾炎的超声声像征象占比。结果:经病理检查单纯性阑尾炎33例、梗阻性阑尾炎4例、化脓性阑尾炎19例和坏疽性阑尾炎16例;经超声诊断单纯性阑尾炎35例、梗阻性阑尾炎2例、化脓性阑尾炎16例和坏疽性阑尾炎19例;以病理检查结果为金标准,超声诊断儿童阑尾炎病理分型的准确度为79.17%(Kappa=0.684);不同病理分期阑尾炎儿童在管壁层次、管腔积液和阑尾周围低回声等超声声像特征占比比较,差异有统计学意义(P<0.05)。结论:超声特征可准确评估儿童阑尾炎的病理分期,不同病理分型的阑尾炎患儿超声特征差异显著,可作为临床鉴别的辅助影像依据。Objective To explore and analyze the relationship between ultrasound characteristics and pathological classifications of appendicitis in children.Methods The clinical data of 72 children with appendicitis were retrospectively analyzed.All patients underwent ultrasound examination,successful resection of acute appendicitis and pathological confirmation.Taking pathological examination results as the golden standard,the Kappa consistency of ultrasound for evaluating pathological classifications of appendicitis was analyzed.The proportions of ultrasound signs in children with different pathological classifications of appendicitis were compared.Results Pathological examination showed that there were 33 cases of simple appendicitis,4 cases of obstructive appendicitis,19 cases of purulent appendicitis and 16 cases of gangrenous appendicitis.Ultrasound diagnosis showed that there were 35 cases of simple appendicitis,2 cases of obstructive appendicitis,16 cases of purulent appendicitis and 19 cases of gangrenous appendicitis.Taking pathological examination results as the golden standard,the accuracy of ultrasound in the pathological classifications of appendicitis was 79.17%(Kappa=0.684).There were significant differences in the proportions of ultrasound signs(tube wall layer,luminal effusion,periappendiceal hypoecho)among children with different pathological classifications of appendicitis(P<0.05).Conclusion Ultrasound characteristics can accurately evaluate the pathological classifications of pediatric appendicitis.The children with different pathological classifications of appendicitis have significantly different ultrasound characteristics which can be applied as auxiliary imaging basis for clinical differentiation.

关 键 词：儿童 阑尾炎 超声特征 病理分型 

分 类 号：R445.1[医药卫生—影像医学与核医学]