Mohamad Sufian Mohamed Burhan, Hamzaini Abd Hamid, Faizah Mohd Zaki, Chai Jia Ning, Isa Azzaki Zainal, Izzat Arslan Che Ros, Che Zubaidah Bt Che Daud, Mohd Yusran Bin Othman, Erica Yee Hing
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引用次数: 0
摘要
背景：对于患有中肠倒置和旋转不良的儿科患者来说，快速诊断对于预防严重并发症至关重要。虽然上消化道检查（UGIS）是传统方法，但超声波（US）的使用正日益受到重视：与上消化道检查相比，评估超声波对旋转不良和中肠空卷的诊断敏感性和特异性：方法：对吉隆坡（PPUKM 和 HTA）68 名儿童患者进行横断面研究，这些患者在手术前接受了 US 和/或 UGIS 检查，以怀疑中肠旋转不良，并将手术结果作为金标准：在诊断肠旋转不良方面，US 的特异性（100%）高于 UGIS（83%），但敏感性略低（97% 对 100%）。对于中肠旋转，US 的灵敏度超过了 UGIS（92.9% 对 66.7%），而特异性则相当。SMA/SMV标准的灵敏度（91.1%）高于US上的D3评估（78.9%），尽管两者的特异性都很高：结论：在识别肠旋转不良方面，US 与 UGIS 的效果相当，而在检测中肠旋转方面，US 的灵敏度更高，因此支持将 US 作为主要诊断工具。该研究主张，当 US 和 UGIS 二者之一无法得出结论时，应联合使用，以优化这些病症的诊断精确度。
The performance of ultrasound and upper gastrointestinal study in diagnosing malrotation in children, with or without volvulus.
Background: Rapid diagnosis is crucial for pediatric patients with midgut volvulus and malrotation to prevent serious complications. While the upper gastrointestinal study (UGIS) is the traditional method, the use of ultrasound (US) is gaining prominence.
Objectives: To assess the diagnostic sensitivity and specificity of US compared to UGIS for malrotation and midgut volvulus.
Methods: A cross-sectional study was performed on 68 pediatric patients who underwent US and/or UGIS before surgery for suspected midgut volvulus or malrotation in Kuala Lumpur (PPUKM and HTA), referencing surgical outcomes as the gold standard.
Results: US demonstrated a higher specificity (100%) than UGIS (83%) for diagnosing malrotation, with a slightly lower sensitivity (97% vs. 100%). For midgut volvulus, US surpassed UGIS in sensitivity (92.9% vs. 66.7%) while maintaining comparable specificity. The SMA/SMV criteria showed better sensitivity (91.1%) than the D3 assessment (78.9%) on US, though both had high specificity.
Conclusion: US is equivalent to UGIS for identifying malrotation and is more sensitive for detecting midgut volvulus, supporting its use as a primary diagnostic tool. The study advocates for combined US and UGIS when either yields inconclusive results, optimizing diagnostic precision for these conditions.
期刊介绍：
To advance and improve the radiologic aspects of emergency careTo establish Emergency Radiology as an area of special interest in the field of diagnostic imagingTo improve methods of education in Emergency RadiologyTo provide, through formal meetings, a mechanism for presentation of scientific papers on various aspects of Emergency Radiology and continuing educationTo promote research in Emergency Radiology by clinical and basic science investigators, including residents and other traineesTo act as the resource body on Emergency Radiology for those interested in emergency patient care Members of the American Society of Emergency Radiology (ASER) receive the Emergency Radiology journal as a benefit of membership!
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