彩色多普勒超声在小儿肠源性腹痛中的诊断价值

【目的】探讨彩色多普勒超声在小儿肠源性腹痛诊断中的应用价值。【方法】回顾性分析因腹痛来本院就诊并经肠道超声检查诊断为肠道异常的患儿的超声资料，分析超声检查的初步诊断结果与确诊结果的符合率及超声特征。【结果】腹部超声检查诊断与确诊结果符合率94．6％（2612／2760），不符合者5．4％（148／2760），包括阑尾炎146例，肠息肉并继发性肠套叠2例；肠套叠的横断扫查图像呈“同心圆征”或“靶环征”，中央呈不规则混合回声；阑尾炎的典型声像图呈蚯蚓或腊肠样回声，边缘毛糙，宽窄不一，壁厚呈双边影，横切面呈双环征，腔内可见不均匀回声；肠旋转不良的彩色多普勒血流图显示红蓝相间的螺旋状血流信号；过敏性紫癜的典型声像图显示为局部肠管扩张，伴不均匀的肠壁增厚，肠腔呈向心性或偏心性狭窄；肠重复畸形的典型声像图表现为腹腔内囊性包块，边界清，壁较厚，囊壁呈三层，由外至内呈强、弱、强回声，即“双环征”；肠息肉的典型声像图显示为边界清晰可具有不规则形态的中等回声结节，内部可见细小囊腔，数量不等；血供丰富。【结论】彩色多普勒超声在小儿肠源性腹痛中诊断价值高，不同病因的腹痛具有特畀性的超声特征。

Value of Color Doppler Ultrasound in the Diagnosis of Pediatric Enterogenous Abdominal Pain

Objective] To explore the value of color Doppler ultrasound in the diagnosis of pediatric en terogenous abdominal pain. Methods]The ultrasound data of pediatric patients who had abdominal pain and were diagnosed as intestinal abnormalities by using intestinal ultrasound examination in our hospital were ana- lyzed retrospectively. The compliance rate between primary diagnosis results of ultrasound and confirmed diag- nosis results and ultrasound characteristics were analyzed. Results] The compliance rate between abdominal ultrasound diagnosis and confirmed diagnosis results was 94.6%（2612/2760）, while the discrepancy rate was 5.4%（148/2760）, including appendicitis（146 cases） and intestinal polyps with secondary intussusceptions（2 cases）. The cross-sectional image of intussusception was ＂ concentric circles＂ or ＂target loop＂. The central echo was irregular and mixed. The typical sonographic images of appendicitis looked like earthworms or sau- sage, and had rough edges, various width and bilateral shadow wall. The cross-sectional image showed bicyclic sign. The uneven echo was found in the cavity. Color Doppler flow image of intestinal malrotation showed blue and red spiral flow signals. The typical sonographie images of allergic purpura showed local intestinal dilatation with uneven thickening of intestinal wall. Intestinal cavity was concentric or eccentric stenosis. The typical sonographic images of intestinal duplication showed intra-abdominal cystic mass with clear border and thick wall. There were three layers in cyst wall of cystic mass, which showed strong, weak, strong echo from out- side to inside i.e. ＂bicyclic sign＂. The typical sonographie images of intestinal polyps showed clear boundary and medium nodules with irregular morphology. The small cysts were visible inside. The number of cysts was varied. The blood supply of cysts was rich. Conclusion] Color Doppler ultrasound in the diagnosis of pediatric enterogenie abdominal pain has high value. Abdominal pain with different causes shows characteristic ultra- sonographic features.