摘要
目的探讨胃窗超声造影在小儿肠系膜上动脉综合征(SMAS)中的诊断价值。方法选取2019年1月—2021年6月我院超声科行胃窗超声造影检查并经上消化道X线钡餐造影诊断为SMAS的患儿23例作为观察组,另选取同期行胃窗超声造影的正常小儿50例作为对照组,对观察组中经胃窗超声造影怀疑SMAS者加行上消化道X线钡餐造影,分析二者诊断一致性;比较2组胃窗超声造影指标,并分析其对小儿SMAS的预测价值。结果本组经胃窗超声造影检查诊断的小儿SMAS与上消化道X线钡餐造影检查的诊断一致性为23/24(95.8%)。观察组肠系膜上动脉-腹主动脉夹角(SMA-AA)及胃腔充盈态仰卧位十二指肠通过处SMA后壁与AA前壁的距离(DD)小于对照组,胃腔充盈态仰卧位十二指肠水平部主动脉-肠系膜上动脉夹角前及夹角处最大内径比值(D前/D夹)和十二指肠反流发生率大于对照组(P<0.05,P<0.01)。应用D前/D夹>3.0及十二指肠水平部是否出现反流初步判断小儿SMAS的敏感度及特异度分别为100.0%、95.6%及87.0%、88.0%。结论胃窗超声造影诊断小儿SMAS与上消化道X线钡餐造影具有很高的一致性,测量和(或)观察SMA-AA、D前/D夹、DD及十二指肠水平部是否出现反流能协助诊断小儿SMAS,并可用于后期随访。
Objective To investigate the value of gastric window contrast-enhanced ultrasonography in diagnosis of children with superior mesenteric artery syndrome(SMAS).Methods A total of 23 children,who had undergone gastric window contrast-enhanced ultrasonography and had been diagnosed as having SMAS by upper gastrointestinal X-ray barium meal between January 2019 and June 2021,were selected as observation group,and other 50 healthy children undergoing gastric window contrast-enhanced ultrasonography at the same period were selected as control group.In observation group,those with suspected SMAS by gastric window contrast-enhanced ultrasonography were supplemented with upper gastrointestinal X-ray barium meal,and the diagnostic consistency of the two methods was analyzed.Indexes of gastric window contrast-enhanced ultrasonography were compared between two groups,and the value of gastric window contrast-enhanced ultrasonography in prediction of children with SMAS was analyzed.Results The diagnostic consistency of SMAS in children diagnosed by gastric window contrast-enhanced ultrasonography and upper gastrointestinal X-ray barium meal was 23/24(95.8%).In observation group,the included angle between superior mesenteric artery and abdominal aorta(SMA-AA)and the distance(DD)between the posterior wall of SMA and the anterior wall of AA at the pass position of duodenum in the supine position with gastric cavity filling were less,while the ratio of the maximum inner diameter of aorta superior mesenteric artery in the horizontal part of duodenum before and at the included angle(pre-d/D-clip)in the supine position with gastric cavity filling and the incidence rate of duodenal reflux were greater than those in control group(P<0.05,P<0.01).The sensitivity and specificity of pre-d/D-clip more than 3.0 and presence of duodenal reflux in judging the development of SMAS in children were 100.0%,95.6%,and 87.0%,88.0%respectively.Conclusion Gastric window contrast-enhanced ultrasonography has good consistency with upper gastrointestinal X-ray barium meal in diagnosis of children with SMAS.Detection and/or observation of SMA-AA,pre-d/D-clip,DD and presence of duodenal reflux in the horizontal part may help diagnose SMAS in children and can be used for subsequent follow-up.
作者
刘景雁
郭永华
肖保军
于洋洋
张锐
LIU Jing-yan;GUO Yong-hua;XIAO Bao-jun;YU Yang-yang;ZHANG Rui(Department of Ultrasound,the People's Hospital of Daxing District,Beijing 102600,China)
出处
《解放军医药杂志》
CAS
2022年第5期51-54,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
北京市大兴区人民医院科研课题(4202102365)。
关键词
肠系膜上动脉综合征
儿童
胃窗超声造影
十二指肠
诊断效能
Superior mesenteric artery syndrome
Child
Gastric window contrast-enhanced ultrasonography
Duodenum
Diagnostic efficiency
