Abstract:

Objective　To analyze the difference in the diagnostic significance of ultrasound and multi-slice spiral CT (MSCT) in children with digestive tract duplication. Methods　The clinical data of 42 children confirmed as digestive tract duplication by surgery and pathology in Guangdong Women and Children Hospital from January 2014 to November 2022 were analyzed retrospectively, including 26 males and 16 females, aged (3.65±2.24) years. All the children were given ultrasound and MSCT examination prior to the surgery. The imaging characteristics of ultrasound and MSCT were analyzed, and the diagnostic significance of the two methods was compared with surgical pathology results as the gold standard. χ² test and corrected χ² test were used. Results　Of the 42 cases, 2 were located in the esophagus, 5 in the jejunum, 20 in the ileum, 8 in the ileocecal region, 1 in the colorectum, 4 in the stomach, and 2 in the duodenum. There were 37 cyst-type cases and 5 tubular-type cases. Compared with the results of surgical pathology, 28 cases were diagnosed met (diagnostic coincidence rate of 66.7%), 9 cases were misdiagnosed (misdiagnosis rate of 21.4%), and 5 cases were missed (missed diagnosis rate of 11.9%) by ultrasound; 34 cases were diagnosed met (diagnostic coincidence rate of 80.9%), 6 cases were misdiagnosed (misdiagnosis rate of 14.3%), and 2 cases were missed (missed diagnosis rate of 4.8%) by MSCT; there were no statistically significant differences in the overall diagnostic coincidence rate, misdiagnosis rate, and missed diagnosis rate between ultrasound and MSCT (all P>0.05). Conclusions　Both ultrasound and MSCT can effectively diagnose digestive tract duplication in children. The overall diagnosis coincidence rate of MSCT is slightly higher than that of ultrasound, and the misdiagnosis rate and missed diagnosis rate are relatively low. However, ultrasound has the advantage of being simple to operate, radiation-free, and real-time dynamic observation, so it can be preferred. The combined application of both methods can provide a powerful reference for clinical determination of the nature and type of the lesion, its specific location, and the formulation of treatment plans.

Key words:

Ultrasound, Multi-slice spiral CT, Digestive tract duplication, Children

摘要：

目的　分析超声与多层螺旋CT（MSCT）在小儿消化道重复畸形中的诊断价值差异。方法　回顾性分析广东省妇幼保健院在2014年1月至2022年11月期间收治的已通过手术病理证实为消化道重复畸形42例患儿的临床资料，其中男性26例，女性16例，年龄（3.65±2.24）岁。所有患儿术前均行超声与MSCT检查，分析超声及MSCT两种检查方法的影像表现特点，以手术病理结果为金标准作对比，比较两种检查方法的诊断价值。使用χ²检验和校正χ²检验。结果　42例消化道重复畸形中，位于食道2例，空肠5例，回肠20例，回盲部8例，结直肠1例，胃4例，十二指肠2例；按类型分，囊肿型37例，管状型5例。与手术病理结果对照，超声诊断符合28例（诊断符合率66.7%），误诊9例（误诊率21.4%），漏诊5例（漏诊率11.9%）；MSCT诊断符合34例（诊断符合率80.9%），误诊6例（误诊率14.3%），漏诊2例（漏诊率4.8%）；超声与MSCT对肠重复畸形的总体的诊断符合率、误诊率及漏诊率差异均无统计学意义（均P>0.05）。结论　超声与MSCT均能够高效诊断小儿消化道重复畸形，MSCT总体诊断符合率略高于超声检查，误诊率及漏诊率相对较低，但超声有操作简便、无辐射及可实时动态观察的优势，可作为检查首选，两者综合应用可为临床确定病灶性质类型、具体部位及制定治疗方案提供有力参考。

关键词:

超声, 多层螺旋CT, 消化道重复畸形, 小儿