用临床评分进行计算机断层扫描,以区分幼儿时代小肠阻塞中的植物虫与便
Ning Wang, Xuedong Wu, Xiaodong Lin1
1Department of Medical Imaging, The First Affiliated Hospital, Dali University, China.
The Turkish journal of pediatrics
|January 11, 2024
概括
在患有小肠阻塞的儿童中诊断phytobezoar具有挑战性. 将计算机断层扫描 (CT) 分析与急性通用紧急手术严重性-小肠阻塞 (AGESS-SBO) 评分系统相结合,可以提高与植物相关的SBO的诊断准确性.
科学领域:
- 儿科手术 儿科手术
- 放射学 放射学是一门学科.
- 胃肠病学 胃肠病学
背景情况:
- 儿童小肠阻塞 (SBO) 诊断可能具有挑战性,特别是当由植物虫引起时.
- 在成像中,小肠便标志 (SBFS) 是SBO的标志,但不能特别识别植物虫.
研究的目的:
- 为了评估定量计算机断层扫描 (CT) 分析的诊断性能,结合急性一般紧急手术严重性-小肠阻塞 (AGESS-SBO) 评分系统.
- 为了提高儿童中与植物相关的SBO的识别准确度.
主要方法:
- 一项回顾性研究比较了16名与植物虫相关的SBO患者 (植物虫组) 和19名SBFS阳性SBO患者 (对照组).
- 分析包括人口统计数据,临床表现,实验室发现和CT发现.
- 定量CT分析的重点是碎片的特性 (长度,衰减).
- 每个患者的AGESS-SBO得分都被计算出来.
- 使用多变量逻辑回归和ROC曲线分析来识别显著变量并评估诊断性能.
主要成果:
- 与对照组相比,phytobezoar组的最大碎片长度显著缩短 (3.0 ± 0.5厘米相比3.5 ± 0.7厘米) 和CT衰减更强 (12.6 ± 5.9 HU相比8.2 ± 4.0 HU).
- 在植物植物群中,AGESS-SBO得分显著更高 (中位数为4.5比2).
- 使用碎片衰减 (> 9.0 HU) 和AGESS-SBO评分 (> 3 分) 的综合方法,在诊断与植物相关的SBO时,获得了80%的正预测值 (PPV) 和84%的负预测值 (NPV).
结论:
- 将定量CT分析与AGESS-SBO评分系统相结合,可以提高SBFS阳性SBO儿童中识别植物的准确性.
- 这种综合诊断方法为管理儿科SBO的临床医生提供了宝贵的工具.
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