超声影像检查在小儿便血病因中的诊断价值

小儿便血是临床常见疾病之一,临床上引起小儿便血的原因很多,如美克尔憩室、结肠息肉、肠套叠、肠重复畸形、克隆氏病、溃疡性结肠炎等;另外少见的腹腔内血管畸形、结肠血管瘤亦可引起便血。超声检查简便易行、无创无痛,结果准确可靠,对小儿便血病因的诊断具有重要临床价值。     

胃超声造影在胃肿瘤诊断中的应用

胃肿瘤是消化系统常见疾病，可分为良性和恶性。良性肿瘤以胃息肉和胃平滑肌瘤较为多见，恶性肿瘤以胃癌最为常见，其发生率在消化道恶性肿瘤中居第1位。传统检查方法主要为胃镜、X线钡餐透视，虽诊断率较高，但也有一定的局限性。胃超声造影通过充盈胃腔，改变胃内环境，可达到显示胃     

高频超声对小儿肠系膜淋巴结炎的诊断价值

肠系膜淋巴结炎是小儿常见的以间歇性腹痛为主的疾病,间歇期间无不适症状。目前,超声检查是确诊该病的唯一方法。本文分析了191例有腹痛症状和12例无腹痛症状儿童肠系膜淋巴结炎患者的超声表现。临床资料:2005年11月至2006年8月,本院收治的191例有腹痛症状的和12例无腹痛症状的儿童患者,均经     

超声在诊断小儿肠套叠的应用价值

目的：探究超声在诊断小儿肠套叠的应用价值。方法资料随机选自2012年5月～2013年5月儿科门诊诊治的腹痛患儿200例,其中临床确诊为小儿肠套叠51例,予以所有患者超声和X线的平片检查,分析两种检查方法对小儿肠套叠的诊断灵敏度及特异度情况。结果超声诊断小儿肠套叠灵敏度92.16％,高于X线平片80.39％;且超声诊断特异度97.99％,高于X线平片62.42％,比较差异均具统计学上的意义（ P＜0.05）。结论将超声检查应用于临床小儿肠套叠的诊断中,相比较应用X线平片的检查,疾病诊断的灵敏度及特异度比较高,具有一定临床应用价值。     

超声检查在小儿肠套叠临床分析

小儿肠系膜生理特点是固定欠佳、回盲部可大范围活动,同时由于支配神经系统功能尚未发育健全,因而如遇肠道病毒感染或肿瘤等病变时,常会因肠蠕动不协调或功能紊乱而发生肠套叠.肠套叠为小儿急腹症中较为常见的疾病,及时准确的诊断和有效的治疗是避免肠管坏死的关键[1～ 3].本文对超声诊断小儿肠套叠138例患者的临床资料进行分析,提高诊断水平.     

高频超声在小儿胃肠道急腹症中的诊断价值

目的探讨超声对小儿胃肠道急腹症的诊断价值。方法分析364例以胃肠道急腹症为主要临床表现患儿的CT诊断资料及超声诊断资料,将CT诊断符合率与超声诊断符合率进行对比性分析。结果急性阑尾炎、肠套叠、肠梗阻、肠系膜淋巴结炎、急性出血性坏死性肠炎、急性过敏性紫癜（腹型）、小儿肠憩室的CT诊断符合率明显低于超声诊断符合率,数据依次为：78．8％vs95．3％,86．6％vs100％,78．6％vs100％,92．0％vs100％,18．2％vs63．6％,10％vs60％,0％vs23％,差异均有统计学意义（ P＜0．05）。结论超声对小儿胃肠道急腹症的诊断具有重要价值,超声可作为诊断小儿胃肠道急腹症的首选影像学方法。     

高频彩色多普勒超声在小儿阑尾炎诊断中的应用价值

目的 观察高频彩色多普勒超声在小儿阑尾炎诊断中的应用价值.方法 将2018年3月至2019年9月兴化市戴南人民医院检查疑为阑尾炎后转入兴化市人民医院手术证实的68例患儿作为研究对象.入选患儿术前均接受高频彩色多普勒超声检查诊断,将手术结果作为"金标准",对高频彩超检查诊断的特异度、敏感度和准确度进行分析.结果 68例疑...     

小儿卵巢肿瘤的超声诊断

目的:探讨彩色多普勒超声诊断小儿卵巢肿瘤的价值。材料和方法:回顾性分析24例超声诊断为小儿卵巢肿瘤的超声声像图表现并与手术、病理结果对照。结果:1例膀胱横纹肌肉瘤误诊为卵巢实质性肿瘤。23例经手术确诊为小儿卵巢肿瘤的病例中,4例超声诊断与病理不符,其中1例卵巢囊肿伴扭转坏死误诊为卵巢成熟畸胎瘤;1例卵巢成熟畸胎瘤伴扭转坏死及2例卵巢上皮性肿瘤伴扭转坏死误诊为卵巢囊肿伴扭转。超声诊断9例卵巢肿瘤伴扭转,术中证实扭转7例,6例坏死。结论:超声诊断小儿卵巢肿瘤及其是否扭转准确性较高,可作为首选影像学检查方法。     

空腹超声诊断胃病变的临床应用

由于胃内气体的影响,以往超声检查胃病变须饮水使胃充盈后进行,因部分患者难以接受且较费时,其应用受到一定限制。我们在日常工作中发现,空腹状态下经腹超声能有效地显示胃壁结构及其病变,因而对此进行了初步临床研究。1　资料与方法1.1　研究对象为本院近年来门诊和住院患者,分为三组。正常对照组:110例,胃镜诊断为慢性浅表性胃炎;胃溃疡组:17例,均为胃镜或手术病理诊断,作为良性对照;胃癌组:29例,均经手术或胃镜病理结果。1.2　仪器美国ATL公司产超9-HDI型彩色超声显像仪,探头频率3.5MHz。1.3　方法患者严格空腹10h以上,仰卧,探头纵切…     

三维超声诊断胃畸胎瘤1例

患者女,64岁.因胃部不适,消化不良体检.查体腹正中可扪及5 0cm×6.0cm包块,活动度良好,无压痛.体温36.8℃.上消化道钡餐检查诊为慢性胃炎,胃动力低.血尿常规检查未见异常.超声检查所见:常规肝胆脾检查未见异常.于肝左叶左后方可探及8.0cm×3.9cm椭圆形无回声,边界清楚,内部回声不均匀,以囊性为主,后古可见声影(图1).三维扫描后成像可见形态规则的囊性包块内有小块状强回声,边界清楚(图2).超声提示腹腔内囊性占位(畸胎瘤可能大).随访患者1年后突发腹痛急诊入院手术后病理诊断胃壁良性畸胎瘤扭转.     

小儿腹痛84例的超声诊断分析

目的探讨超声对小儿腹痛的诊断价值。方法回顾性分析84例以腹痛为主要症状的患儿超声声像图特点,比较不同疾病患儿超声表现的差异性。结果84例患儿中,超声诊断为肠系膜淋巴结炎34例,急性阑尾炎13例,诊断准确率100％;肠痉挛21例;肠系膜淋巴结结核4例,1例伴有结核性腹膜炎：肠套叠2例;淋巴瘤1例;9例B超下未发现阳性声像图表现,随访最后诊断为慢性胃炎6例,肠道蛔虫病2例,慢性阑尾炎1例。结论超声检查诊断小儿腹痛准确性较高,可以大大减少临床上诊断及治疗的盲目性,值得推广应用。     

Abdominal sonography in examination of children with blunt abdominal trauma

OBJECTIVE: The objective of our study was to evaluate abdominal sonography for the detection of fluid and organ injury in children with blunt abdominal trauma. SUBJECTS AND METHODS: Fifty-one consecutive children with blunt abdominal trauma requiring abdominal CT were prospectively examined with sonography. Sonograms and CTs were independently evaluated by two radiologists for fluid and organ injury; CT examinations were considered abnormal if either was identified. Differences in CT interpretation were settled by a third observer. Using CT as the truth standard, we calculated the sensitivity, specificity, and negative predictive value of sonography for both observers. Agreement of the sonographic interpretations was evaluated using kappa statistic. RESULTS: In 33.3% of patients, CT revealed fluid, organ injury, or both. The sensitivity and specificity of sonography when detection of fluid was the sole parameter evaluated was 58.8% and 79.4%, respectively, for observer 1 and 47.1% and 79.4%, respectively, for observer 2. In contrast, the sensitivity and specificity of sonography when detection of both fluid and organ injury was evaluated was 64.7% and 79.4%, respectively, for observer 1 and 70.6% and 70.6%, respectively, for observer 2. The negative predictive value of sonography was 79.4% and 75.0% with evaluation limited to detection of fluid and 81.8% and 82.8% with evaluation of fluid and organ abnormality for observers 1 and 2 , respectively. Agreement was excellent for sonographic identification of fluid (kappa = 0.82) but poor for detection of organ injury (kappa = 0.34). CONCLUSION: The low sensitivity and negative predictive value of sonography when assessing for either fluid alone or fluid and organ injury suggest that a normal screening sonography alone in the setting of blunt abdominal trauma fails to confidently exclude the presence of an intraabdominal injury.     

胶囊内镜对慢性腹痛的诊断分析

目的分析胶囊内镜在慢性腹痛中的诊断价值。方法 2008年9月-2009年7月慢性腹痛25例、无消化道症状体检20例进行胶囊内镜检查,对诊断结果进行相关统计学分析。结果胶囊内镜均顺利完成检查,全部胶囊在检查结束后排出体外。检查过程中患者无任何不适。慢性腹痛患者中,小肠溃疡3例（12%）,小肠息肉3例（12%）,十二指肠扭转1例（4%）,空肠静脉瘤1例（4%）,空肠蛔虫病1例（4%）,回肠黏膜糜烂1例（4%）。无消化道症状的体检者中,小肠息肉2例（10%）,回肠黏膜糜烂1例（5%）。小肠疾病在慢性腹痛患者中检出率40%,明显高于无消化道症状的体检者（15%）,两者比较有统计学意义（P〈0.01）。两组的胃排空时间分别为（40.99±31.38）min和（37.90±24.89）min,到达回盲部时间分别为（220.89±91.64）min和（225.68±80.59）min,两组比较无统计学意义（P〉0.05）。结论胶囊内镜在慢性腹痛的诊断中有良好价值,临床安全性好。     

D-DOM技术在儿童腹上区CT检查中的应用价值

目的:探讨在线动态剂量调节(D-DOM)扫描技术在儿童腹上区CT检查中的应用价值。方法:选取行腹上区CT扫描的患儿100例,研究组和对照组各50例,研究组使用D-DOM技术,对照组不使用D-DOM技术。记录两组病例扫描时机器自动显示的剂量长度乘积(DLP),并计算有效剂量(ED)值,同时记录研究组每例患者扫描图像上每层的mAs值。两组每例均取肝顶部、肝门及肝底部各1帧图像(共300帧),由两位副主任医师采用盲法评价图像质量,测量上述相同层面图像噪声并进行统计学处理。结果:研究组比对照组mAs最大下降54.00,平均下降18.46,两组间差异有统计学意义(P<0.05);图像质量主观评价,研究组肝顶部层面优良率为100%,略高于对照组(98.00%),肝门部两组病例优良率均为100%,但对照组优级片(78%)高于研究组(46%);肝底部两组病例优良率均为100%;研究组图像噪声平均值为3.6±1.1,对照组为3.4±1.0,两组病例图像噪声比较差异无统计学意义(t=0.477,P>0.05)。结论:儿童患者腹上区CT检查使用D-DOM技术进行实时在线mAs调节,既可以提高射线的利用效率从而降低辐射剂量,又能保证图像质量,具有一定的实际应用价值。     

腹腔镜及开腹术式对慢性阑尾炎患者疼痛及腹腔粘连的影响

目的：结合临床实践经验,探讨腹腔镜及开腹术式对慢性阑尾炎患者疼痛及腹腔粘连的影响。方法：按照手术方式的不同,将患者分为开腹手术组（67例）和腹腔镜手术组（65例）。两组患者在性别、年龄、病情等一般资料方面差别无统计学意义（P〉0.05）,具有可比性。通过对比两组患者在术中、术后的情况及处理,并随访患者慢性腹痛以及肠粘连的情况,探讨其临床应用价值。结果：术中出血、住院时间、术中粘连以及术后疼痛比较中,开腹手术组和腹腔镜组两组差异有统计学意义。手术时间比较中两组差异无统计学意义。结论：腹腔镜组术中出血与住院时间明显少于开腹手术组,提示腹腔镜手术术中出血少、住院时间短的优点。腹腔镜能对腹腔内进行彻底的探查,更多的发现患者腹腔内粘连并治疗,术后慢性疼痛少于开腹手术组,具有明显的优势,值得临床推广。     

Combined radionuclide and ultrasonic assessment of upper abdominal masses in children.

Two young adults and 22 children with upper abdominal masses were evaluated by hepatic scintigraphy and gray scale ultrasonography. Abnormal static scintigrams were subdivided into two groups on the basis of tumor vascularity as shown on the initial dynamic portion of the study. Ultrasonic evaluation resulted in four categories: uniformly densely reflective, densely reflective with internal sonolucencies, poorly reflective with some internal components, and sonolucent. Images of liver perfusion and radionuclide accumulation (scintigraphy) plus images of internal architecture (ultrasonography) allow accurate assessment of intra- or juxtahepatic masses. The combined information was more useful than that from either study alone.     

Acute abdominal pain in children: usefulness of three-view abdominal radiographs in the emergency department

Diagnostic imaging is often an integral component in the workup of a pediatric patient with acute abdominal pain. The purpose of this study was to compare the diagnostic value of a three-view acute abdominal series (AAS) with that of a single supine view (SSV) in children with acute abdominal pain. All subjects aged ≤18 years that underwent an emergency three-view AAS examination for acute abdominal pain at a single urban hospital system were included. Retrospective evaluation of radiological diagnosis, number of radiological images, further imaging, management, and clinical outcomes was performed. “Positive” AAS studies were compared with corresponding SSV images for direct comparison of diagnostic value. Standard nonparametric statistical evaluation was performed. Five hundred forty-one AAS studies were included in the study. Greater than three radiographs were acquired in 29 % (153/541) of the subjects. Two hundred ninety-nine out of 541 AAS studies included a technically adequate SSV of the abdomen and pelvis. Most AAS examinations were categorized as negative (n = 485; 90 %). Of the 56 examinations initially classified as positive, there was no significant statistical difference between diagnostic accuracy between the AAS and SSV on retrospective evaluation. For pediatric subjects with nontraumatic acute abdominal pain, the yield of conventional radiographic study is exceedingly low. If required, a technically adequate single supine anteroposterior (AP) view of the abdomen and pelvis is sufficient for initial radiographic evaluation while reducing unnecessary radiation exposure to the patient.