Comparison of two examination methods in the diagnosis of acute intestinal obstruction in children
-
摘要: 目的 比较64层螺旋CT与数字化X线摄影(DR)技术在小儿急性肠梗阻诊断中的应用价值。 方法 选取本院疑似急性肠梗阻患儿81例为研究对象,均给予DR和CT检查。以手术或随访结果为“金标准”,分析2种检查方法诊断的准确率。 结果 81例患儿中,肠梗阻患儿58例, CT和DR诊断灵敏度分别为91.38%和87.93%, 特异度分别为86.96和82.61%, 准确率分别为90.12%和86.42%, 一致性Kappa值分别为0.763和0.679, McNemar检验结果显示, 2种检查方法差异无统计学意义(P>0.05); 58例肠梗阻患儿中,粘连性梗阻19例,肠套叠16例,先天性肠梗阻11例,嵌顿疝5例,坏死性肠炎3例以及肠扭转4例,CT和DR对肠梗阻病因检查准确率分别为91.38%和75.86%, 差异有统计学意义(P<0.05); 58例肠梗阻患儿中,小肠低位梗阻48例(82.76%), 小肠高位梗阻6例(10.34%), 结肠梗阻4例(6.90%)。CT和DR对梗阻部位检查准确率分别为94.83%和82.76%, 差异有统计学意义(P<0.05)。 结论 CT对小儿肠梗阻诊断准确率与DR检查相当,但对梗阻病因和部位判断较DR具有明显优势。Abstract: Objective To compare the value of 64-slice spiral CT and digital radiography(DR)in the diagnosis of acute intestinal obstruction in children. Methods Eighty-one children with suspected acute intestinal obstruction were selected. All patients were given DR and CT examinations. The diagnostic accuracy rates of the two examination methods were analyzed by taking surgery or follow-up results as golden standards. Results Among the 81 children patients, there were 58 cases with intestinal obstruction, with a sensitivity of 91.38% in CT and 87.93% in DR, a specificity of 86.96% and 82.61%, respectively, the accuracy rate of 90.12% and 86.42%, respectively, and the consistency Kappa value of 0.763 and 0.679, respectively. McNemar test results showed no significant difference between the two groups(P>0.05). Among 58 children patients with intestinal obstruction, there were 19 cases with adhesive obstruction, 16 cases with intussusception, 11 cases with congenital intestinal obstruction, 5 cases with incarcerated hernia, 3 cases with necrotic enteritis and 4 cases with volvulus, and the accuracy rates of CT and DR for etiology of intestinal obstruction were 91.38% and 75.86%, respectively(P<0.05). Among 58 children patients with intestinal obstruction, there were 48 cases(82.76%)with low intestinal obstruction, 6 cases(10.34%)with high intestinal obstruction and 4 cases(6.90%)with colon obstruction, with the accuracy rates of CT and DR for the obstruction site examination were 94.83% and 82.76%, respectively(P<0.05). Conclusion The accuracy rate of CT in diagnosis of intestinal obstruction is comparable to that of DR, but CT has obvious advantages over DR in the etiology and sites of obstruction.
-
Keywords:
- acute intestinal obstruction /
- diagnosis /
- 64-slice spiral CT /
- digital radiography
-
-
SHAH M, GALLAHER J, MSISKA N, et al. Pediatric intestinal obstruction in Malawi: characteristics and outcomes[J]. Am J Surg, 2016, 211(4): 722-726.
王建峰, 程丽红, 席红卫, 等. p38MAPK对小儿急性肠梗阻肠坏死Occludin表达的影响及临床意义[J]. 中华小儿外科杂志, 2017, 38(2): 95-98. 张世胜, 杨超, 郑燕, 等. CT、DR、超声检查在诊断肠梗阻的临床应用[J]. 四川医学, 2013, 34(2): 301-303. 高彦春. 小儿肠梗阻中DR技术的应用效果分析[J]. 中国医疗设备, 2017, 32(S2): 28-28. 贾晋荣. 小承气汤保留灌肠联合保守治疗小儿肠梗阻63例效果观察[J]. 中国药物与临床, 2019, 19(1): 76-77. ALEXANDER S. Image Acquisition and Quality in Digital Radiography. [J]. Radiol Technol, 2016, 88(1): 53-66.
楼其赟, 叶文海, 叶菲. 肠梗阻的腹部X线平片和CT诊断价值对比[J]. 医学影像学杂志, 2017, 27(11): 2237-2239. 秦好朴, 孙吉林, 周建峰, 等. 降低小儿胸部数字X线摄影(DR)辐射剂量的临床研究[J]. 临床放射学杂志, 2016, 35(2): 272-275. 张帆, 夏万泓, 刘建军, 等. 多层螺旋CT多平面重建技术在急性肠梗阻病因诊断中的应用[J]. 广西医科大学学报, 2016, 33(3): 503-506. HE B, GU J, HUANG S, et al. Diagnostic performance of multi- slice CT angiography combined with enterography for small bowel obstruction and intestinal ischaemia[J]. J Med Imaging Radiat Oncol, 2017, 61(1): 40-47.
杨涌, 戚士芹, 未德成, 等. 小儿急性肠梗阻诊治分析[J]. 安徽医学, 2015, 36(9): 1109-1110. 鲁开文, 亓小虎. DR与多层螺旋CT对肠梗阻的诊断价值比较[J]. 西南国防医药, 2019, 29(4): 76-78.
计量
- 文章访问数: 320
- HTML全文浏览量: 96
- PDF下载量: 11