基层医院高频超声及X线诊断婴儿发育性髋关节发育不良的应用价值

发布时间：2018-06-24 15:53

本文选题：超声 + X线　；参考：《放射学实践》2015年07期

【摘要】：目的:探讨基层医院高频超声及X线诊断婴儿发育性髋关节发育不良(DDH)的应用价值。方法:选择本院确诊为DDH的患儿共35例(58髋)。对比分析患儿的超声与X线检查的一致性,统计分析独立使用α角、β角以及综合Graf法结果诊断DDH的敏感度、特异度、符合率、阳性预测值、阴性预测值。结果:X线检查诊断为DDH的符合率为72.2%,比超声检查的86.1%低,但差异无统计学意义(χ2=2.105,P=0.147);但两者联合诊断DDH的符合率达100%,较X线或超声单独诊断均高。X线和超声检查结果的kappa值为0.794,可见两种检查结果基本一致。超声Graf法诊断DDH的敏感度、特异度、符合率、阳性预测值和阴性预测值分别为86.1%、100%、91.7%、100%、82.8%,而用超声Graf法测量的α角和β角独立诊断DDH的敏感度、特异度、符合率、阳性预测值和阴性预测值分别为83.3%、100%、90.0%、100%、80.0%和77.8%、100%、86.7%、100%、75.0%。结论:对于婴儿DDH的诊断符合率,超声检查较X线高,而两者联合应用可达100%。两项检查各有特点,需要临床医师结合婴儿及设备等情况合理选择。
[Abstract]:Objective: to evaluate the value of high frequency ultrasound and X-ray in diagnosis of developmental hip dysplasia (DDH) in primary hospitals. Methods: a total of 35 cases (58 hips) of DDH were selected. The sensitivity, specificity, coincidence rate, positive predictive value and negative predictive value of DDH with 伪 angle, 尾 angle and comprehensive Graf method were compared and analyzed. Results the coincidence rate of the diagnosis of DDH was 72.2%, which was lower than that of ultrasonic examination (86.1%). But there was no significant difference (蠂 ~ 2 / 2.105), but the coincidence rate of the two methods was 100, which was higher than that of X-ray or ultrasound alone. The kappa value of X-ray and ultrasonic examination was 0.794, which showed that the results of two kinds of examinations were basically the same. The sensitivity, specificity, coincidence rate, positive predictive value and negative predictive value of ultrasound Graf method in the diagnosis of DDH were 86.1 / 100 and 91.7 / 100, respectively. The sensitivity, specificity and coincidence rate of 伪 angle and 尾 angle measured by Graf method in the diagnosis of DDH were determined independently. The positive predictive value and the negative predictive value were 83.3% and 90.0%, 80.0% and 77.8%, respectively. Conclusion: the diagnostic coincidence rate of DDH in infants is higher than that in X-ray. The two tests have their own characteristics and need rational selection by clinicians in combination with infants and equipment.
【作者单位】：佛山市顺德区均安医院超声科;佛山市顺德区均安医院放射科;
【基金】：佛山市医学类科技攻关项目(201308297)
【分类号】：R726.8;R816.92

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