小儿全结肠型巨结肠的X线诊断

目的分析评价X线在TCA的影像特点及诊断价值。方法对经手术病理证实的13例小儿TCA的腹部平片及钡灌肠征象进行回顾性分析。结果13例腹部平片均显示异常，表现为不同程度小肠淤张、结肠少气或无气，结合临床可提示巨结肠可能；钡灌肠显示：结肠框变小10例，整个结肠壁较平坦、僵直、缺乏正常的柔韧度与活动度9例，部分结肠壁不光整、呈现齿状突起5例、钡剂逆流、末端回肠扩大9例，24h钡剂潴留8例。钡灌肠正确诊断TCA10例，诊断准确率达76．9％。结论腹部平片异常可提示巨结肠，是诊断TCA的首选方法；钡灌肠可以正确诊断TCA，是目前诊断TCA主要的影像检查方法．正确合理使用检查方法、掌握TCA影像特征表现．对早期诊断TCA具有萤大的意义．

Radiographic diagnosis of total colonic aganglionosis in children

Objective To evaluate the diagnostic value and imaging characteristics of radiography for total colonic aganglionosis(TCA). Methods Thirteen child patients with TCA underwent plain film examination of abdomen and radiography of colon with barium enema. Results The plain films showed abnormalities in all patients such as the dilation in small intestine in different degrees and little or no gas in the colon.Thus combined with clinical,it could be diagnosed as aganglionosis.The barium enema imaging showed that in 10 cases the colon frame became smaller;in 9 cases entire colon walls were smooth and unbending,and lacked the normal tenacity and activity;in 5 cases the partial colon wall was not smooth but dentate;in 9 cases the reverse and the dilated terminal ileum ware observed;and in 8 cases the barium was still detrained after 24 h.Diagnostic accurate rate was 76.9%. Conclusion Abdomen plain film examination is the first method to TCA.The barium enema examination is the main method for TCA,and can diagnose correctly aganglionosis.