小儿难复性肠套叠临床与MDCT的表现特征

发布时间：2018-05-11 20:07

本文选题：难复性肠套叠 + 儿童　；参考：《实用医学杂志》2017年09期

【摘要】：目的:探讨小儿难复性肠套叠的临床和多排螺旋CT(MDCT)表现特征。方法:对19例难复性肠套叠和47例可复性肠套叠的临床与MDCT特征进行对比分析,包括年龄、病程、套叠体部长度(L)、套颈最大横径(D1)、套头最大横径(D2)、套头与套颈最大横径比值(D2/D1)与伴随影像征象。结果:(1)难复性肠套叠的病程、L和D2/D1值均大于对照组,而D1小于对照组,差异有统计学意义(P0.05);病程、L和D2/D1值对应的曲线下面积(AUC)值均0.7,临界值分别为33.0个月、7.5 cm和1.33。(2)难复性肠套叠多发生非回-结肠套的复杂性肠套叠(36.8%)、分别合并美克尔憩室(21.1%)、肠管坏死(21.1%)、阑尾炎(15.8%)、肠梗阻(10.5%)。结论:对于病程33.0个月、L7.5 cm、D2/D11.33的小儿肠套叠提示难复性肠套叠的可能,并应观察有无合并美克尔憩室、肠管坏死、阑尾炎和肠梗阻的存在。
[Abstract]:Objective: to investigate the clinical and multi-row spiral CTMDCT features of refractory intussusception in children. Methods: the clinical and MDCT features of 19 cases of refractory intussusception and 47 cases of refractory intussusception were compared and analyzed, including age, course of disease. The maximum transverse diameter of the overlay was D _ 2 / D _ 1 and the ratio of the maximum transverse diameter to the maximum transverse diameter of the sleeve was D _ 2 / D _ 1. Results (1) the course L and D2/D1 values of refractory intussusception were higher than those of control group, while D1 was lower than that of control group. The difference was statistically significant (P 0.05); the area under the curve corresponding to the L and D2/D1 values of the course of disease were 0.7.The critical values were 33.0 months (7.5cm and 1.33.2respectively) the complex intussusception with non-ileo-colonic intussusception occurred frequently (36.8%), which combined with Meckel respectively. Diverticulum was 21. 1%, intestinal necrosis was 21. 1%, appendicitis was 15. 8%, intestinal obstruction was 10. 5%. Conclusion: for children with intussusception of L7.5 cm ~ (2 / D) / D _ (11.33) during the course of 33.0 months, the possibility of refractory intussusception is suggested, and the presence of Meckel's diverticulum, intestinal necrosis, appendicitis and intestinal obstruction should be observed.
【作者单位】：河南科技大学第一附属医院分子影像中心;河南科技大学第一附属医院影像科;
【基金】：河南省卫生科技创新型人才工程(2010~2020年)专项经费资助项目(编号:04205)
【分类号】：R725.7;R816.92

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