核素显像对小儿消化道出血的诊断价值  

DDThe Clinical Value and Influencing Factors when Using Nuclein Imaging in Children with Gastrointestinal Bleeding

作　　者：彭旭兰[1] 梁宏伟[1] 张宝牛[1] 刘炯[1] 候军夫[1] 

机构地区：[1]山西医科大学第二医院核医学科,山西太原030001

出　　处：《中国误诊学杂志》2003年第9期1309-1310,共2页Chinese Journal of Misdiagnostics

摘　　要：目的 :评价核素显像对小儿消化道出血的诊断价值。方法 :对 4 4例患儿先进行 99m Tc O4 -腹部动态显像 ,其中 30例呈阳性结果者则进行手术治疗 ,余 14例阳性者进一步做99m Tc- RBC腹部动态显像后再做手术。结果 :130例99m Tc O4 - 显像阳性结果中 2 9例发现异位胃粘膜。 2 14例在 99m Tc- RBC显像中 9例发现出血灶 ,3例病理有胃粘膜。 399m Tc O4 - 对儿童消化道出血的检出率为 6 8.18% ,联合99m Tc- RBC显像后增至 88.6 4 %。99m Tc O4 - 显像对诊断异位胃粘膜的灵敏度、特异性、准确性分别为 90 .6 3%、91.6 7%、90 .91% ,假阴性率和假阳性率分别为 9.37%和 8.33%。结论 :核素显像是一种无创、简便、可靠 ,对小儿消化道出血有重要诊断价值的检查手段。宜先行 99m Tc O4 -显像 ,阴性者再进行 99m Tc-RBC显像。Objective:To evalute the clinical value when using nuclein imaging in children gastrointestinal bleeding.Methods: 99m TcO 4 - abdomen dynamic imaging was performed on 44 patients,30 of which had positivity results and were scheduled for the surgical operation,the other had negativity results and underwent farther 99m Tc-RBC imaging.Results:①29 of 30 with positivity result cases in 99m TcO 4 - imaging were found ectopic stomach mucosa.②9 of 14 patients showed bleeding focus in 99m Tc-RBC imaging,3 of which presented gastric mucosa according to the histology.③ 99m TcO 4 - joint 99m Tc-RBC imaging could increase the detecting rate from 68.18% to 88.64%.The sensitivity、specificity、accuracy with 99m TcO 4 - imaging for ectopic gastric mucosa were 90.63%,91.67%,90.91%,respectively,and the false negativity and false positivity were 9.37% and 8.33%,respectively.Conclusion:Nuclein imaging was a noninvasive、simple and reliable detective method in diagnosis the gastrointestinal bleeding in children.The 99m TcO 4 - imaging should be first used, and the 99m Tc-RBC imaging was performed if negative results occurred using the former method.

关 键 词：胃肠出血/放射性核素显像 儿童 回顾性研究 

分 类 号：R725.7[医药卫生—儿科]