摘要
目的观察腹部彩色多普勒超声检查对儿童结肠息肉的诊断价值。方法选取2017年1月至2020年1月在温州市中医院就诊的疑似结肠息肉患儿300例为研究对象,患儿分别进行结肠镜检查和腹部彩色多普勒超声检查,以结肠镜检查结果为金标准,评价腹部彩色多普勒超声检查对儿童结肠息肉的诊断价值,并分析腹部彩色多普勒超声检查对不同位置、类型和病灶大小儿童结肠息肉的诊断符合率。结果腹部彩色多普勒超声检查对儿童结肠息肉的诊断灵敏度为87.60%(113/129),特异性为97.08%(166/171),诊断总体符合率为93.00%(279/300),阳性预测值为95.76%(113/118),阴性预测值为91.21%(166/182)。腹部彩色多普勒超声检查对于升结肠、横结肠、降结肠、乙状结肠和直肠位置的儿童息肉病变诊断符合率分别为85.71%(12/14)、83.33%(10/11)、87.50%(10/11)、86.79%(46/53)和89.47%(17/19),对于幼年性息肉、黑斑息肉综合征和腺瘤样息肉诊断符合率分别为86.17%(81/94)、92.31%(24/26)和88.89%(8/9),腹部彩色多普勒超声检查对不同位置和不同类型儿童结肠息肉病变的诊断符合率差异均无统计学意义(χ2=0.250、0.721,P=0.993、0.697)。腹部彩色多普勒超声检查对直径≤1 cm儿童结肠息肉病变诊断符合率(38.09%)均显著低于其对1 cm<直径<3 cm和直径≥3 cm的儿童结肠息肉病变诊断符合率(95.38%和100.00%)(χ2=34.400、33.404,P=0.000、0.000)。结论腹部彩色多普勒超声检查可准确诊断儿童结肠息肉,适用于儿童结肠息肉筛查,具有较高临床应用价值,然而对于直径≤1 cm病灶检测具有一定局限性。
Objective To evaluate the clinical value of abdominal color Doppler ultrasonography in the differential diagnosis of colonic polyps in children.Methods From January 2017 to January 2020,300 children with suspected colonic polyps were studied.All patients were examined by colonoscopy and abdominal color Doppler ultrasound respectively.The results of colonoscopy were taken as the gold standard to evaluate the diagnostic efficacy of abdominal color Doppler ultrasound in the differential diagnosis of colonic polyps in children.The diagnostic accuracy of abdominal color Doppler ultrasound in diagnosis of colonic polyps in children with different location,type and focus size was analyzed.Results The diagnostic sensitivity and specificity of abdominal color Doppler ultrasound for colonic polyps in children were 87.60%(113/129)and 97.08%(166/171),respectively.The overall diagnostic accuracy was 93.00%(279/300),the positive predictive value was 95.76%(113/118),and the negative predictive value was 91.21%(166/182).The diagnostic accuracy of abdominal color Doppler ultrasound were 85.71%(12/14),83.33%(10/11),87.50%(28/32),86.79%(46/53)and 89.47%(17/19)for children's polyps in ascending colon,transverse colon,descending colon,sigmoid colon and rectum,and were 86.17%(81/94),92.31%(24/26)and 88.89%(8/9)for juvenile polyps,black spot polyp syndrome and adenomatous polyps,respectively.There were no statistically significant differences between the two groups(χ2=0.250,0.721;P=0.993,0.697).The diagnostic accuracy of abdominal color Doppler ultrasound in children with diameter≤1 cm(38.09%)was significantly lower than that in children with 1 cm<diameter<3 cm and diameter≥3 cm(95.38%and 100.00%)(χ2=34.400,33.404;P=0.000,0.000).Conclusion Abdominal color Doppler ultrasound can accurately diagnose children's colonic polyps,which is suitable for screening children's colonic polyps,and has high clinical application value.However,it has certain limitations for the detection of lesions with diameter≤1 cm.
作者
刘万田
潘鸿
何佩佩
Liu Wantian;Pan Hong;He Peipei(Department of Ultrasound,Wenzhou Hospital of Traditional Chinese Medicine,Wenzhou,Zhejiang 325000,China)
出处
《中国基层医药》
CAS
2020年第17期2112-2116,共5页
Chinese Journal of Primary Medicine and Pharmacy
