高频超声对小儿肠系膜淋巴结炎的诊断价值
|
摘要
目的探讨高频超声对小儿肠系膜淋巴结炎的诊断价值。方法对88例肠系膜淋巴结炎患儿(病例组)和90例体检的健康儿童(正常对照组)进行彩色多普勒超声检查,观察2组的肠系膜淋巴结的分布、形态、数量、大小及血流显示情况。结果病例组的肠系膜淋巴结短轴径、长轴径均明显大于正常对照组(P<0.05或P<0.01)。病例组绝大多数肠系膜淋巴结呈椭圆形低回声。界限清晰、规整,包膜完整、光滑,中央髓质呈稍高回声区,周围皮质呈低回声区,皮、髓质分界清晰。可清晰地显示肾形结构,多见数个至数十个,呈散在、串珠状及簇状堆积分布,偶有重叠,但少见融合现象。结论正常儿童中可以出现肿大的肠系膜淋巴结,淋巴结的大小并非是诊断急性肠系膜淋巴结炎的特异性指标。高频超声对小儿肠系膜淋巴结炎的诊断具有重要价值,为临床诊治及鉴别诊断提供依据。
Objective To explore the diagnostic value of high-frequency ultrasonography in mesenteric lymphadenitis in children. Methods Color doppler ultrasound was performed in 88 children with mesenteric lymphadenitis(case group) and 90 healthy children(normal control group). The distribution, shape,number and size of mesenteric lymph nodes and the bloodstream demonstration situation were observed in both groups. Results Compared with normal control group,the diameters of long and short axles of mesenteric lymph nodes significantly greated in case group(P<0.05 or P<0.01). Moreover,the vast majority of mesenteric lymph nodes in case group showed oval hypoechoic structures with clear and neat boundary and complete and smooth envelope. The central medulla was visualized as slightly hyperechoic area and the cortex as hypoechoic area. There was a clear boundary between cortex and medulla. Furthermore,high-frequency ultrasonography showed clear kidney structure with scattered, beaded and clustered distribution of several to dozens of mesenteric lymph nodes,which occasionally overlapped but rarely fused. Conclusion Enlarged mesenteric lymph nodes may appear in normal children and the size of lymph nodes is not the specific indicator in the diagnosis of acute mesenteric lymphadenitis. High-frequency ultrasonography can provide a valuable basis for differential diagnosis and clinical treatment of mesenteric lymphadenitis in children.
Objective To explore the diagnostic value of high-frequency ultrasonography in mesenteric lymphadenitis in children. Methods Color doppler ultrasound was performed in 88 children with mesenteric lymphadenitis(case group) and 90 healthy children(normal control group). The distribution, shape,number and size of mesenteric lymph nodes and the bloodstream demonstration situation were observed in both groups. Results Compared with normal control group,the diameters of long and short axles of mesenteric lymph nodes significantly greated in case group(P<0.05 or P<0.01). Moreover,the vast majority of mesenteric lymph nodes in case group showed oval hypoechoic structures with clear and neat boundary and complete and smooth envelope. The central medulla was visualized as slightly hyperechoic area and the cortex as hypoechoic area. There was a clear boundary between cortex and medulla. Furthermore,high-frequency ultrasonography showed clear kidney structure with scattered, beaded and clustered distribution of several to dozens of mesenteric lymph nodes,which occasionally overlapped but rarely fused. Conclusion Enlarged mesenteric lymph nodes may appear in normal children and the size of lymph nodes is not the specific indicator in the diagnosis of acute mesenteric lymphadenitis. High-frequency ultrasonography can provide a valuable basis for differential diagnosis and clinical treatment of mesenteric lymphadenitis in children.
引文
[1]祝伟宏,欧玉平,周小平,等.超声诊断儿童肠系膜淋巴结炎的价值[J].中国临床医学影像杂志,2010,21(7):517-518.
[2]杨颖丽,陈琍,任国华,等.小儿肠系膜淋巴结炎108例临床分析[J].临床荟萃,2006,21(12):874.
[3]孙彬,陶静,初洪钢,等.浅表淋巴结病变的声像图特征及病因病理分析[J].中华超声影像学杂志,2001,10(11):679-681.
[4]洪舒拉.急性肠系膜淋巴结炎的超声诊断[J].中国超声诊断杂志,2003,4(1):35-36.
[5]Carty H M.Paediatric emergencies:non-traumatic abdominal emergencies[J].Eur Radiol,2002,12(12):2835-2848.
[6]叶菊芬.高频彩超对小儿急性肠系膜淋巴结炎的诊断意义[J].实用医学杂志,2009,25(16):2795.
[7]李建华.高频彩色多普勒超声在诊断及鉴别诊断小儿肠系膜淋巴结炎中的应用价值[J].吉林医学,2012,33(11):2382.
[8]Ridolfini M P,Alfieri S,Gourgiotis S,et al.Risk factors associated with pancreatic fistula after distal pancreatectomy,which technique of pancreatic stump closure is more beneficial[J].World J Gastroenterol,2007,13(38):5096-5100.
[9]甄本山.高频超声诊断小儿急性肠系膜淋巴结炎的价值研究[J].中国现代医生,2010,48(19):88-89.
[10]史晓龙,周国平.小儿肠系膜淋巴结炎的超声诊断[J].临床超声医学杂志,2002,4(1):49.
[11]Peng S Y,Wang J W,Lau W Y,et al.Conventional versus binding pancreaticojejunostomy after pancreaticoduodenectomy:a prospective randomized trial[J].Ann Surg,2007,245(5):692-698.
[12]张晓蓉,陈菲,邢淑玲,等.肠系膜淋巴结炎患儿92例高频超声表现及分析[J].中日友好医院学报,2011,25(4):210-212,215,F0003.
[13]刘贵麟.小儿急性阑尾炎与肠系膜淋巴结炎[J].中华小儿外科杂志,2004,25(4):363.
[14]胡亚美,江载芳,诸福棠.实用儿科学[M].7版.北京:人民卫生出版社,2008:1362.
[2]杨颖丽,陈琍,任国华,等.小儿肠系膜淋巴结炎108例临床分析[J].临床荟萃,2006,21(12):874.
[3]孙彬,陶静,初洪钢,等.浅表淋巴结病变的声像图特征及病因病理分析[J].中华超声影像学杂志,2001,10(11):679-681.
[4]洪舒拉.急性肠系膜淋巴结炎的超声诊断[J].中国超声诊断杂志,2003,4(1):35-36.
[5]Carty H M.Paediatric emergencies:non-traumatic abdominal emergencies[J].Eur Radiol,2002,12(12):2835-2848.
[6]叶菊芬.高频彩超对小儿急性肠系膜淋巴结炎的诊断意义[J].实用医学杂志,2009,25(16):2795.
[7]李建华.高频彩色多普勒超声在诊断及鉴别诊断小儿肠系膜淋巴结炎中的应用价值[J].吉林医学,2012,33(11):2382.
[8]Ridolfini M P,Alfieri S,Gourgiotis S,et al.Risk factors associated with pancreatic fistula after distal pancreatectomy,which technique of pancreatic stump closure is more beneficial[J].World J Gastroenterol,2007,13(38):5096-5100.
[9]甄本山.高频超声诊断小儿急性肠系膜淋巴结炎的价值研究[J].中国现代医生,2010,48(19):88-89.
[10]史晓龙,周国平.小儿肠系膜淋巴结炎的超声诊断[J].临床超声医学杂志,2002,4(1):49.
[11]Peng S Y,Wang J W,Lau W Y,et al.Conventional versus binding pancreaticojejunostomy after pancreaticoduodenectomy:a prospective randomized trial[J].Ann Surg,2007,245(5):692-698.
[12]张晓蓉,陈菲,邢淑玲,等.肠系膜淋巴结炎患儿92例高频超声表现及分析[J].中日友好医院学报,2011,25(4):210-212,215,F0003.
[13]刘贵麟.小儿急性阑尾炎与肠系膜淋巴结炎[J].中华小儿外科杂志,2004,25(4):363.
[14]胡亚美,江载芳,诸福棠.实用儿科学[M].7版.北京:人民卫生出版社,2008:1362.