彩超诊断小儿肠系膜淋巴结炎的临床意义  

Clinical significance of color ultrasound in diagnosis of infantile mesenteric lymphadenitis

作　　者：胡春玲 Hu Chunling(Color Ultrasound Room,West Lake Town Health Center,Donggang District,Rizhao Shandong,276800,China)

机构地区：[1]日照市东港区西湖镇卫生院彩超室,山东日照276800

出　　处：《中外女性健康研究》2024年第1期47-49,共3页Women＇s Health Research

摘　　要：目的:探讨彩色多普勒血流显像(color doppler flow imaging,CDFI)诊断小儿肠系膜淋巴结炎的临床价值。方法:回顾性分析2020年1月至2022年12月本院收治的86例疑似小儿肠系膜淋巴结炎的患儿临床资料,均行常规超声及CDFI检查,统计肠系膜淋巴结炎检出情况,并以临床综合诊断为金标准,分析两种超声诊断小儿肠系膜淋巴结炎的灵敏度、特异度、准确度、阳性预测值、阴性预测值;采用kappa检验验证两种超声诊断小儿肠系膜淋巴结炎与临床综合诊断的一致性;比较肠系膜淋巴结炎患儿治疗前后血流状况变化;比较本病与非本病患儿最大肠系膜淋巴结横径、纵径差异;分析超声图像表现。结果:86例疑似患儿经临床综合诊断确诊68例为肠系膜淋巴结炎,其中常规超声检出60例,阳性检出率为88.24%;CDFI检出67例,阳性检出率为98.53%;CDFI诊断小儿肠系膜淋巴结炎的灵敏度、准确度高于常规超声(P<0.05);kappa检验显示,常规超声诊断小儿肠系膜淋巴结炎与临床综合诊断的一致性尚可(kappa=0.698,P=0.000),CDFI诊断小儿肠系膜淋巴结炎与临床综合诊断的一致性极好(kappa=0.897,P=0.000);68例患儿治疗后无血流占比高于治疗前(P<0.05);肠系膜淋巴结炎患儿最大肠系膜淋巴结横径、纵径高于非肠系膜淋巴结炎患儿(P<0.05);肠系膜淋巴结炎:肠系淋巴结多分布于右下腹,形态呈椭圆形、肾形,包膜完整,呈均匀低回声,皮髓质界限模糊,且血流显像存在血流信号,以条状血流多见。正常肠系膜淋巴结:可探及淋巴结分布于右下腹、脐周居多,形态上呈长椭圆形、肾形,低回声,血流显像示内部无血流信号,也可伴星点状血流。结论:CDFI在小儿肠系膜淋巴结炎诊断中价值较高,可提高疾病诊断的灵敏度、准确度,便于开展针对性治疗。Objective:To investigate the clinical value of color Doppler ultrasound(CDFI)in our hospital.Methods:Clinical data of 86 suspected children with mesenteric lymphadenitis admitted to Xihu Town Health Center,Donggang District,Rizhao City from January 2020 to December 2022 were retrospectively analyzed.Routine ultrasound and CDFI examination were performed to analyze the detection of mesenteric lymphadenitis,and comprehensive clinical diagnosis was taken as the gold standard.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of two kinds of ultrasonography in the diagnosis of children with mesenteric lymphadenitis were analyzed.kappa test was used to verify the consistency of two kinds of ultrasonic diagnosis of pediatric mesenteric lymphadenitis and clinical comprehensive diagnosis.The changes of blood flow in children with mesenteric lymphadenitis were compared before and after treatment.The maximal transverse diameter and longitudinal diameter of mesenteric lymph nodes were compared between the children with and without this disease.Ultrasonic image performance was analyzed.Results:Of 86 suspected children,68 cases were confirmed as mesenteric lymphadenitis by clinical comprehensive diagnosis,of which 60 cases were detected by routine ultrasound,the positive detection rate was 88.24%.CDFI was detected in 67 cases,and the positive rate was 98.53%.The sensitivity and accuracy of CDFI in the diagnosis of mesenteric lymphadenitis in children were higher than those of conventional ultrasound(P<0.05).kappa test showed that the consistency between conventional ultrasound diagnosis and clinical comprehensive diagnosis was reasonable(kappa=0.698,P=0.000),and the consistency between CDFI diagnosis and clinical comprehensive diagnosis was excellent(kappa=0.897,P=0.000).The proportion of no blood flow in 68 cases after treatment was higher than before treatment(P<0.05).The maximum transverse diameter and longitudinal diameter of mesenteric lymph nodes in children with mesenteric lymp

关 键 词：小儿肠系膜淋巴结炎 彩色多普勒血流显像 超声图像表现 

分 类 号：R445.1[医药卫生—影像医学与核医学]