摘要
目的通过总结不同年龄段儿童急性胰腺炎(AP)、慢性胰腺炎(CP)的超声特征探讨超声对不同年龄段儿童胰腺炎的诊断价值。方法回顾性分析2013年1月至2018年6月间首都儿科研究所附属儿童医院住院治疗并接受超声检查的81例AP及CP患儿的声像图和相关临床资料,对比分析23例低龄儿(≤5岁)和58例大龄儿(>5岁)的超声表现。结果23例低龄儿均为AP(含复发性AP),58例大龄儿中41例(71%)为AP,17例(29%)为CP。两组AP患儿在胰腺超声表现异常、胰腺体积增大、胰腺回声增强、回声不均、胰管扩张、胰管结石、胰腺钙化、胰腺包膜不光滑、胰周组织回声增强及胰周积液、假性囊肿、胆总管扩张和门静脉血栓等方面的发生率差异均无统计学意义。低龄组患儿弥散性胰腺体积增大的发生率显著高于大龄组患儿(88%比52%,P<0.05),大龄组患儿局部性胰腺增大的发生率高于低龄组患儿(48%比13%,P<0.05),且增大多集中于胰体尾部。超声提示胆总管扩张的9例(39%)低龄组患儿均经手术证实为胆总管囊肿,胆总管扩张的8例大龄儿组患儿中6例(15%)经手术证实为胆总管囊肿,两组胆总管囊肿发生率差异有统计学意义(P<0.05)。CP均为大龄儿,47%(8/17)表现为胰腺体积缩小,100%(17/17)胰腺回声不均匀,82%(14/17)合并胰管扩张,29%(5/17)合并假性囊肿,18%(3/17)合并胰腺钙化及胰管结石。结论对低龄儿童进行超声扫查时应关注可导致胰腺炎发生的先天解剖异常,如胆总管囊肿;对大龄儿童应尽量做到胰腺的全面扫查,关注胰体尾部的病变,还应特别关注大龄儿童CP的发生。
Objective To assess the diagnostic value of ultrasound for pediatric pancreatitis in different ages via summarizing the ultrasonographic characterizations of pediatric acute pancreatitis(AP)and chronic pancreatitis(CP)patients in different ages.Methods From January 2013 to June 2018,ultrasonographic images and related clinical data of 81 AP and CP children hospitalized in Children′s Hospital of Capital Institute of Pediatrics were retrospectively analyzed.Patients were divided into two age groups:0-5 and 5-18 years(23 and 58 patients respectively).The ultrasonography of 23 little children(≤5 years old)and 58 big kids(>5 years old)was compared.Results All 23 little children were diagnosed as AP,including recurrent AP.41 of 58 big kids(71%)were diagnosed as AP,and 17(29%)were as CP.There were no significant differences between AP little children and AP big kids on the incidence of abnormal findings in pancreatic ultrasound,enlargement of pancreas,increased echogenicity of pancreas,heterogeneous pancreas,dilation of pancreatic duct,ductal calculus,calcification,unsmooth capsule of pancreas,increased echogenicity of peripancreatic tissue and peripancreatic fluid collection,pseudocyst,common bile duct dilatation and portal vein system thrombosis.Diffuse enlargement of the pancreas was seen more frequently in little children than big kids(88%vs 52%),while localized pancreatic enlargement occurred more often in big kids than little children(48%vs 13%),and both the differences were statistically significant(P<0.05).Ultrasonography indicated that 9(39%)little children with common bile duct dilatations were eventually diagnosed as choledochal cysts by surgery,while 6(15%)of the 8 big kids with common bile duct dilatations were confirmed to be choledochal cysts by surgery,and the difference on the incidence of choledochal cysts was statistically significant(P<0.05).All the CP patients were big kids.47%(8/17)of CP big kids had parenchymal atrophy,100%(17/17)had heterogeneous pancreas,82%(14/17)had pancreatic duct dilatio
作者
马亚
刘琴
张薇薇
任红雁
张勇
王峥嵘
Ma Ya;Liu Qin;Zhang Weiwei;Ren Hongyan;Zhang Yong;Wang Zhengrong(Department of Ultrasound,Children′s Hospital of Capital Institute of Pediatrics,Beijing 100020,China)
出处
《中华胰腺病杂志》
CAS
2020年第1期22-26,共5页
Chinese Journal of Pancreatology
基金
首都儿科研究所所级基金(QN-2019-06)。
关键词
超声检查
胰腺炎
儿童
Ultrasonography
Pancreatitis
Child
