CDFI与 ECT 对婴儿梗阻性黄疸的诊断价值分析

摘要

Objective To explore the differential diagnosis value of Color Doppler Flow Imaging ( CDFI ) and Emission Computed Tomography ( ECT) in infant obstructive jaundice .Methods The ultrasonic manifestation and ECT data of 48 infant cases with obstructive jaundice were retrospectively analyzed .Physical signs in surgery and pathologic examination were taken as the golden standard , and the outcomes of two examinations were compared .Results Twenty-six cases of biliary atresia , 18 cases of viral cholestatic hepatitis and 4 cases of primary sclerosing cholangitis were diagnosed by CDFI .Seven cases were not diagnosed definitely , among whom 3 cases were false positive and 4 cases were false negative .The sensitivity, specificity and accuracy for CDFI in detecting infant obstructive jaundice were 74.1%, 87.5% and 89.5%, respectively.Thirty-three cases of biliary atresia, 11 cases of viral cholestatic hepatitis and 4 cases of primary sclerosing cholangitis were diagnosed by ECT , with 6 cases of false positive.The sensitivity, specificity and accuracy for ECT were 100.0%, 71.4%and 91.5%, respectively.There were significant differences in sensitivity and specificity between two methods (χ2 value was 5.69 and 3.98, respectively, both P<0.05), but the difference in accuracy was not significant (P>0.05).Conclusion Both CDFI and ECT play important role in diagnosis and differential diagnosis of infant obstructive jaundice .CDFI is more specific , but ECT is highly sensitive.Diagnostic accuracy can be improved when CDFI is combined with ECT .%目的：探讨彩色多普勒超声（CDFI）与放射性核素肝胆动态显像（ECT）对婴儿梗阻性黄疸的诊断及鉴别诊断价值。方法回顾性分析48例婴儿梗阻性黄疸的超声表现及ECT资料，并以术中所见及术后病理诊断胆道闭锁为金标准，对二者诊断的准确性进行对比评价。结果 CDFI提示胆道闭锁26例，假阳性3例，假阴性4例；淤胆型肝炎综合征18例，胆管炎性改变4例；误诊7例，诊断灵敏度为74．1％、特异度为87．5％、准确性为89．5％。 ECT提示胆道闭锁33例，淤胆型肝炎综合征11例，胆管炎性改变4例；误诊6例，诊断灵敏度为100．0％、特异度为71．4％、准确性为91．5％。两种诊断方法灵敏度及特异度差异均具有统计学意义（χ2值分别为5．69、3．98，均P＜0．05），准确性无明显差异（P＞0．05）。结论 CDFI与ECT均有助于婴儿梗阻性黄疸的诊断及鉴别诊断，CDFI诊断特异性较高，ECT诊断则敏感性较高，二者结合可提高诊断的准确性。