CAJ | 학술논문

目的探讨儿童先天性肠旋转不良的超声诊断价值。方法回顾分析73例先天性肠旋转不良患儿的术前声像图表现，评价超声诊断的敏感性和特异性。结果声像图表现为：（1）胃、十二指肠扩张70例（95.89％）；（2）下消化道肠管呈塌瘪状58例（79.45％）；（3）肠系膜血管呈螺旋状盘曲52例（71.23％）；（4）肠系膜上动脉（SMA）与肠系膜上静脉（SMV）位置关系异常14例（19.18％）；（5）肠管囊性团块8例（10.96％）；（6）肠套叠2例（2.74％）。声像图显示肠系膜血管呈螺旋状盘曲对诊断中肠扭转的敏感性为87.72％、特异性为87.50％，对中肠扭转的阳性预测价值为96.15％。结论中肠扭转的声像图表现具有特征性。肠旋转不良的声像图表现与病理类型有关，提高对该病的病理类型及其超声表现的认识，有助于提高术前诊断率。
목적탐토인동선천성장선전불량적초성진단개치。방법회고분석73례선천성장선전불량환인적술전성상도표현，평개초성진단적민감성화특이성。결과성상도표현위：（1）위、십이지장확장70례（95.89％）；（2）하소화도장관정탑별상58례（79.45％）；（3）장계막혈관정라선상반곡52례（71.23％）；（4）장계막상동맥（SMA）여장계막상정맥（SMV）위치관계이상14례（19.18％）；（5）장관낭성단괴8례（10.96％）；（6）장투첩2례（2.74％）。성상도현시장계막혈관정라선상반곡대진단중장뉴전적민감성위87.72％、특이성위87.50％，대중장뉴전적양성예측개치위96.15％。결론중장뉴전적성상도표현구유특정성。장선전불량적성상도표현여병리류형유관，제고대해병적병리류형급기초성표현적인식，유조우제고술전진단솔。
Objective To investigate the value of ultrasound diagnosis in children with congenital intestinal malrotation.Methods We analysis the ultrasound feature of 73 patients with congenital intestinal malrotation retrospectively ,and evaluate the sensitivity and specificity of the ultrasound diagnosis .Results Ultrasound feature were including:(1)gastric,duodenal dilatation in 70 cases(95.89%);(2)small intestine of lower digestive tracts were empty,with no liquid or gas in 70 cases(79.45%);(3)mesenteric vessels had “spiral”sign in 52 cases (71.23%);(4) superior mesenteric artery ( SMA) and superior mesenteric vein ( SMV) malposition in 14 cases (19.18%);(5)thick-walled cystic mass in 8 cases(10.96%);(6)intestine invagination in 2 cases(2.74%).The“helical winding”of mesenteric vascular was the characteristical ultrasound diagnosis of midgut volvulus ,of which the sensitivity and specificity were 87.72% and 87.50% respectively,and the positive predictive value was 96.15%. Conclusions The ultrasound feature of midgut volvulus are characteristically .The relationship of ultrasound findings and pathologic types of intestinal malrotation are important to preoperative diagnosis and need more forward study .