{"title":"在儿科急诊科检测急腹症患儿腹内自由空气的超声诊断性能：一项回顾性研究。","authors":"Takahiro Hosokawa MD, Yumiko Sato MD, Yutaka Tanami MD, Kyoichi Deie MD, Ryusuke Nambu MD, Itaru Iwama MD, Hiroshi Kawashima MD, Eiji Oguma MD","doi":"10.1002/jum.70032","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>This study aimed to investigate the diagnostic performance of ultrasonography in evaluating intra-abdominal free air in pediatric patients with acute abdomen.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This retrospective study evaluated pediatric patients with abdominal symptoms who underwent ultrasonography before computed tomography (CT), the gold standard for diagnosing intra-abdominal air. The diagnostic performance of ultrasonography was determined based on this standard. In pediatric patients with intra-abdominal free air, free air sizes (massive or focal), and age were compared between those in whom free air was and was not detected on ultrasonography using Fisher's exact and Mann–Whitney <i>U</i> tests.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 240 patients were evaluated. Among the 14 patients with intra-abdominal free air, 10 patients were correctly diagnosed using ultrasonography. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of ultrasonography for detecting intra-abdominal free air were 98.3% (236/240), 71.4% (10/14), 100% (226/226), 100% (10/10), and 98.3% (226/230), respectively. Although the differences were not statistically significant, diagnosis tended to be more difficult in patients with focal free air and older age (massive versus focal free air and ages in patients with ultrasonographically detected versus undetected free air = 6/4 versus 0/4, <i>P</i> = .084; age: 5.2 ± 6.4 years [0–16.7 years] versus 11.6 ± 5.2 years [5.7–16.8 years], <i>P</i> = .089).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Ultrasonography has satisfactory diagnostic accuracy for detecting intra-abdominal free air in pediatric patients with acute abdomen, but not all cases are detected. Examiners and physicians should consider further examinations and management for these patients.</p>\n </section>\n </div>","PeriodicalId":17563,"journal":{"name":"Journal of Ultrasound in Medicine","volume":"44 10","pages":"1913-1925"},"PeriodicalIF":2.4000,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diagnostic Performance of Ultrasonography for Detecting Intra-Abdominal Free Air in Pediatric Patients With Acute Abdomen at a Pediatric Emergency Care Unit\",\"authors\":\"Takahiro Hosokawa MD, Yumiko Sato MD, Yutaka Tanami MD, Kyoichi Deie MD, Ryusuke Nambu MD, Itaru Iwama MD, Hiroshi Kawashima MD, Eiji Oguma MD\",\"doi\":\"10.1002/jum.70032\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>This study aimed to investigate the diagnostic performance of ultrasonography in evaluating intra-abdominal free air in pediatric patients with acute abdomen.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>This retrospective study evaluated pediatric patients with abdominal symptoms who underwent ultrasonography before computed tomography (CT), the gold standard for diagnosing intra-abdominal air. The diagnostic performance of ultrasonography was determined based on this standard. In pediatric patients with intra-abdominal free air, free air sizes (massive or focal), and age were compared between those in whom free air was and was not detected on ultrasonography using Fisher's exact and Mann–Whitney <i>U</i> tests.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 240 patients were evaluated. Among the 14 patients with intra-abdominal free air, 10 patients were correctly diagnosed using ultrasonography. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of ultrasonography for detecting intra-abdominal free air were 98.3% (236/240), 71.4% (10/14), 100% (226/226), 100% (10/10), and 98.3% (226/230), respectively. Although the differences were not statistically significant, diagnosis tended to be more difficult in patients with focal free air and older age (massive versus focal free air and ages in patients with ultrasonographically detected versus undetected free air = 6/4 versus 0/4, <i>P</i> = .084; age: 5.2 ± 6.4 years [0–16.7 years] versus 11.6 ± 5.2 years [5.7–16.8 years], <i>P</i> = .089).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Ultrasonography has satisfactory diagnostic accuracy for detecting intra-abdominal free air in pediatric patients with acute abdomen, but not all cases are detected. Examiners and physicians should consider further examinations and management for these patients.</p>\\n </section>\\n </div>\",\"PeriodicalId\":17563,\"journal\":{\"name\":\"Journal of Ultrasound in Medicine\",\"volume\":\"44 10\",\"pages\":\"1913-1925\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-08-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Ultrasound in Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/jum.70032\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ACOUSTICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Ultrasound in Medicine","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jum.70032","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ACOUSTICS","Score":null,"Total":0}
引用次数: 0
摘要
目的：探讨超声对小儿急腹症腹腔内自由空气的诊断价值。方法：本回顾性研究评估了有腹部症状的儿童患者在CT前进行超声检查，CT是诊断腹腔内空气的金标准。根据该标准确定超声检查的诊断性能。在有腹内自由空气的儿科患者中，使用Fisher's exact和Mann-Whitney U试验比较超声检查中有和没有检测到自由空气的患者的自由空气大小（大块或局灶性）和年龄。结果：共评估240例患者。在14例腹内自由空气患者中，超声诊断正确的有10例。超声检测腹腔内自由空气的诊断准确率为98.3%(236/240)，灵敏度为71.4%(10/14)，阳性预测值为100%(226/226)，阳性预测值为100%(10/10)，阴性预测值为98.3%（226/230）。虽然差异无统计学意义，但局灶性自由空气患者的诊断往往更困难，年龄越大(超声检测到大量自由空气vs局灶性自由空气，超声检测到未检测到自由空气患者的年龄= 6/4 vs 0/4, P = 0.084；年龄:5.2±6.4年(0 - 16.7年)和11.6±5.2年(5.7 - -16.8年),P = .089)。结论：超声对小儿急腹症腹腔内自由空气的检测具有满意的诊断准确性，但并非所有病例均能检出。检查人员和医生应考虑对这些患者进行进一步检查和管理。
Diagnostic Performance of Ultrasonography for Detecting Intra-Abdominal Free Air in Pediatric Patients With Acute Abdomen at a Pediatric Emergency Care Unit
Objectives
This study aimed to investigate the diagnostic performance of ultrasonography in evaluating intra-abdominal free air in pediatric patients with acute abdomen.
Methods
This retrospective study evaluated pediatric patients with abdominal symptoms who underwent ultrasonography before computed tomography (CT), the gold standard for diagnosing intra-abdominal air. The diagnostic performance of ultrasonography was determined based on this standard. In pediatric patients with intra-abdominal free air, free air sizes (massive or focal), and age were compared between those in whom free air was and was not detected on ultrasonography using Fisher's exact and Mann–Whitney U tests.
Results
A total of 240 patients were evaluated. Among the 14 patients with intra-abdominal free air, 10 patients were correctly diagnosed using ultrasonography. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of ultrasonography for detecting intra-abdominal free air were 98.3% (236/240), 71.4% (10/14), 100% (226/226), 100% (10/10), and 98.3% (226/230), respectively. Although the differences were not statistically significant, diagnosis tended to be more difficult in patients with focal free air and older age (massive versus focal free air and ages in patients with ultrasonographically detected versus undetected free air = 6/4 versus 0/4, P = .084; age: 5.2 ± 6.4 years [0–16.7 years] versus 11.6 ± 5.2 years [5.7–16.8 years], P = .089).
Conclusions
Ultrasonography has satisfactory diagnostic accuracy for detecting intra-abdominal free air in pediatric patients with acute abdomen, but not all cases are detected. Examiners and physicians should consider further examinations and management for these patients.
期刊介绍：
The Journal of Ultrasound in Medicine (JUM) is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories, including Original Research papers, Review Articles, Pictorial Essays, Technical Innovations, Case Series, Letters to the Editor, and more, from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community.
Represented through these efforts are a wide variety of disciplines of ultrasound, including, but not limited to:
-Basic Science-
Breast Ultrasound-
Contrast-Enhanced Ultrasound-
Dermatology-
Echocardiography-
Elastography-
Emergency Medicine-
Fetal Echocardiography-
Gastrointestinal Ultrasound-
General and Abdominal Ultrasound-
Genitourinary Ultrasound-
Gynecologic Ultrasound-
Head and Neck Ultrasound-
High Frequency Clinical and Preclinical Imaging-
Interventional-Intraoperative Ultrasound-
Musculoskeletal Ultrasound-
Neurosonology-
Obstetric Ultrasound-
Ophthalmologic Ultrasound-
Pediatric Ultrasound-
Point-of-Care Ultrasound-
Public Policy-
Superficial Structures-
Therapeutic Ultrasound-
Ultrasound Education-
Ultrasound in Global Health-
Urologic Ultrasound-
Vascular Ultrasound
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