高频超声诊断儿童肘关节隐匿骨折的临床价值  

Clinical Value of High-frequency Ultrasound in the Diagnosis of Occult Elbow Fracture in Children

作　　者：王蕾 赵娜蕊 杨菲 路鑫铭 刘慧新[3] WANG Lei;ZHAO Narui;YANG Fei;LU Xinming;LIU Huixin(Department of Ultrasound,Xingtai General Hospital of North China Medical and Health Group,Xingtai,Hebei 054000,China;Department of Critical Care Medicine,Xingtai General Hospital of North China Medical and Health Group,Xingtai,Hebei 054000,China;Department of Ultrasound,the Third Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]华北医疗健康集团邢台总医院超声科,河北邢台054000 [2]华北医疗健康集团邢台总医院重症医学科,河北邢台054000 [3]河北医科大学附属第三医院超声科,石家庄050000

出　　处：《临床误诊误治》2023年第6期64-67,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫生健康委员会科研项目(20190115);邢台市科学技术局项目(2021ZC074)。

摘　　要：目的 探讨高频超声诊断儿童肘关节隐匿骨折的临床价值。方法 选取2020年1月—2022年4月收治的疑似肘关节隐匿骨折患儿112例的临床资料,统计疑似肘关节隐匿骨折患儿高频超声及病理诊断结果,分析高频超声诊断儿童肘关节隐匿骨折价值,探讨高频超声和病理诊断儿童肘关节隐匿骨折部位一致性,比较肘关节隐匿骨折和无骨折患儿高频超声征象及肘前脂肪垫厚度,分析高频超声征象及肘前脂肪垫厚度诊断儿童肘关节隐匿骨折的价值。结果 以病理诊断结果为金标准,高频超声诊断儿童肘关节隐匿骨折的敏感度为87.10%(54/62),特异度为96.00%(48/50),准确度为91.07%(102/112);高频超声和病理诊断儿童肘关节隐匿骨折部位一致性的Kappa值0.961,符合率98.15%。肘关节隐匿骨折患儿高频超声检查肌肉损伤或血肿征、关节积液征、骨皮质连续性中断征、脂肪垫征阳性率及肘前脂肪垫厚度均高于或厚于无骨折患儿(P<0.01)。高频超声肌肉损伤或血肿征、骨皮质连续性中断征及肘前脂肪垫厚度诊断儿童肘关节隐匿骨折的曲线下面积均在0.7以上,具有一定诊断价值(P<0.01)。结论 高频超声诊断儿童肘关节隐匿骨折与病理诊断一致性较高,具有一定诊断价值。Objective To investigate the clinical value of high-frequency ultrasound in diagnosing occult elbow fracture in children.Methods The clinical data of 112 children with suspected occult elbow fracture admitted from January 2020 to April 2022 were selected to analyze the diagnostic results of high-frequency ultrasound and pathology in children with suspected occult elbow fracture.The value of high-frequency ultrasound in the diagnosis of occult elbow fracture in children was analyzed,and the consistency of high-frequency ultrasound and pathology in the diagnosis of occult elbow fracture in children was explored.High-frequency ultrasound signs and the thickness of the fat pad in front of the elbow in children with occult elbow fracture and those without fracture were compared,and the value of the high-frequency ultrasound signs and the thickness of the fat pad in front of the elbow in the diagnosis of occult elbow fracture in children were analyzed.Results With pathological diagnosis as the gold standard,the sensitivity,specificity and accuracy of high-frequency ultrasound in the diagnosis of occult elbow fracture in children were 87.10%(54/62),96.00%(48/50)and 91.07%(102/112),respectively.The Kappa value of consistency in the diagnosis of occult elbow fractures in children by high-frequency ultrasound and pathology was 0.961,and the coincidence rate was 98.15%.The positive rates of muscle injury or hematoma,joint effusion,discontinuity of the bone cortex,fat pad sign and thickness of fat pad in front of the elbow were higher or thicker in children with occult elbow fracture by high-frequency ultrasound than in children without fracture(P<0.01).The area under the curve of high-frequency ultrasound in the diagnosis of occult elbow fractures in children was above 0.7 with muscle injury or hematoma,discontinuity of cortical bone,and thickness of fat pad in front of the elbow,which had certain diagnostic value(P<0.01).Conclusion High-frequency ultrasound is consistent with the pathological diagnosis in the diagnosis of

关 键 词：骨折 肘关节 儿童 高频超声 病理 诊断 Kappa检验 受试者工作特征 

分 类 号：R726.8[医药卫生—儿科]