摘要
目的:比较高频超声与X线对新生儿坏死性小肠结肠炎(Necrotizing enterocolitis,NEC)不同临床分期的诊断价值。方法:回顾性分析2019年1月—2021年1月收住我院新生儿科并确诊NEC的患儿100例,男57例,女43例,比较不同分期NEC高频超声与X线影像学特征及检出率,比较高频超声与X线诊断不同分期NEC阳性率。结果:100例患儿根据临床Bell’s分期标准,Bell分期Ⅰ期50例,Ⅱ期37例,Ⅲ期13例。高频超声与X线比较,高频超声对肠壁水肿增厚、腹水、局部穿孔征象有更高的检出率,X线对肠管充气扩张及充气分布不均有更高的检出率,差异有统计学意义(P<0.05),其它如肠壁积气、门静脉积气、持续固定肠袢/超声表现为肠壁薄、肠蠕动消失,气腹,二者检出率无明显差异(P>0.05)。高频超声诊断NEC阳性率85.00%,X线诊断阳性率80.00%,二者诊断NEC有较好的一致性(Kappa=0.75,P<0.05)。NECⅠ期、Ⅱ期、Ⅲ期高频超声与X线诊断阳性率分别为:84.00%、83.78%、92.31%及90.00%、78.38%、46.15%。NECⅠ期与NECⅡ期诊断阳性率比较,高频超声与X线差异无统计学意义(P>0.05),NECⅢ期二者间比较,高频超声诊断阳性率高于X线,差异比较有统计学意义(P<0.05)。结论:高频超声比X线检查更加安全无创,对肠管组织形态变化的观察更为细致和全面,对NEC分期诊断二者具有较好的一致性,尤其对需要手术的NECⅢ期患儿,高频超声比X线更具优势,在指导临床治疗方面有重要意义,值得临床推广应用。
Objective:To compare the diagnostic value of high-frequency ultrasound and X-ray in different clinical stages of neonatal necrotizing enterocolitis(NEC).Methods:Retrospective analysis of 100 children(57 males and 43 females)with NEC admitted to the neonatal department of our hospital from January 2019 to January 2021 was performed.The characteristics and detection rates of high-frequency ultrasound and X-ray imaging of NEC in different stages were compared.The positive rates of NEC in different stages were compared between high-frequency ultrasound and X-ray.Results:According to the clinical Bell’s staging standard,there were 50 cases in stageⅠ,37 cases in stageⅡ,13 cases in stageⅢ.Compared with X-ray,high-frequency ultrasound indicated a higher detection rate of edema and thickening of intestinal wall,ascites,and local perforation.X-ray has a higher detection rate of intestinal inflation expansion and uneven inflation distribution(P<0.05).Others,such as pneumatosis in intestinal wall,pneumatosis in portal vein,continuous fixation of intestinal loop/ultrasonography manifested thin intestinal wall,disappearance of intestinal peristalsis,pneumoperitoneum,there was no significant difference between them(P>0.05).The positive rate of ultrasonic diagnosis of NEC was 85.00%,and the positive rate of X-ray diagnosis was 80.00%,with excellent consistency in the diagnosis of NEC(Kappa=0.75,P<0.05).The positive rates of high-frequency ultrasound and X-ray diagnosis in NEC stageⅠ,ⅡandⅢwere respectively 84.00%,83.78%,92.31%and 90.00%,78.38%,46.15%.There was no significant difference between high-frequency ultrasound and X-ray in the positive rate of NEC stageⅠand NEC stageⅡ(P>0.05).The positive rate of ultrasound diagnosis was higher than that of X-ray in NEC stageⅢ(P<0.05).Conclusion:Ultrasound is safer and noninvasive than X-ray examination,with a more detailed and comprehensive observation of intestinal tissue morphological changes.These two are consistent in the diagnosis of NEC staging.Especially for t
作者
刘娜
刘婷
黄丽丽
程继文
LIU Na;LIU Ting;HUANG Li-li;CHENG Ji-wen(The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
2023年第1期37-40,45,共5页
Journal of China Clinic Medical Imaging
基金
陕西省重点研发计划(2021SF-219)。
