多层螺旋CT联合彩色多普勒超声对小儿先天性胆总管囊肿的诊断价值分析

摘要 目的：探讨多层螺旋CT（MSCT）联合彩色多普勒超声对小儿先天性胆总管囊肿（CCC）的诊断价值。方法：选取2018年1月～2021年12月来我院治疗的78例CCC患儿为研究对象，所有患儿均接受彩色多普勒超声检查及MSCT检查，以病理诊断结果为金标准，对比两种检查方法对CCC的诊断价值。结果：所有CCC患儿中均未出现肝门部纤维斑块（TC征）阳性、肝动脉内径增宽，33例出现囊肿内胆泥沉积和肝内胆管扩张，16例出现胆囊异常；囊肿长径、宽径分别为（5.41±0.60）cm、（3.26±0.38）cm，脾脏内径为（1.56±0.17）cm。所有患者的Todani分型结果显示：Ⅰ型67例，Ⅱ型2例，Ⅲ型2例，Ⅳ型5例，Ⅴ型2例。与病理学诊断结果对比，彩色多普勒超声对CCC患儿Todani分型有一定的诊断效能，对Ⅰ型、Ⅳ型、Ⅴ型的诊断准确率分别为83.33%、93.59%、93.59%（P＜0.05）。与病理学诊断结果对比，MSCT对CCC患儿Todani分型有较好的诊断效能，对Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型、Ⅴ型的诊断准确率分别为88.46%、89.74%、93.59%、94.87%、97.43（P＜0.05）。彩色多普勒超声联合MSCT检查的诊断准确率高达96.15%，明显高于两种方法单独应用（P＜0.05）。结论：不同Todani分型的CCC患儿具有不同的超声征象，彩色多普勒超声及MSCT对CCC患儿Todani分型均有一定的的诊断价值，且两者联合应用时诊断价值较高。

Diagnostic Value of Multi-Slice Spiral CT Combined with Color Doppler Ultrasound in Children with Congenital Choledochal Cyst

ABSTRACT Objective: To explore the diagnostic value of multi-slice spiral CT (MSCT) combined with color Doppler ultrasound in children with congenital choledochal cyst (CCC). Methods: A total of 78 children with CCC treated in our hospital from January 2018 to December 2021 were selected as the study subjects. All children were examined by color Doppler ultrasound and MSCT, taking the pathological diagnosis as the gold standard, and the diagnostic value of the two examination methods for CCC was compared. Results: None of the children with CCC showed positive hilar fibrous plaque (TC sign) and widened inner diameter of the hepatic artery, 33 cases showed cystic internal bile mud deposition and intrahepatic bile duct dilation, and 16 cases showed gallbladder abnormalities. The length and width of the cyst were (5.41±0.60) cm and (3.26±0.38) cm, respectively, and the inner diameter of the spleen was (1.56±0.17) cm. Compared with the pathological diagnosis results, color Doppler ultrasound had a certain diagnostic efficiency in Todani classification of children with CCC. The diagnostic accuracy of type I, type IV and type V were 83.33%, 93.59% and 93.59% respectively (P<0.05). Compared with the pathological diagnosis results, MSCT had better diagnostic efficiency in Todani classification of children with CCC. The diagnostic accuracy of type I, type II, type III, type IV and type V were 88.46%, 89.74%, 93.59%, 94.87% and 97.43 respectively (P<0.05). The diagnostic accuracy of color Doppler ultrasound combined with MSCT is as high as 96.15% was high as 96.15%, significantly higher than the two methods applied alone (P<0.05). Conclusion: Children with CCC with different Todani classification have different CT signs of ultrasound, both Color Doppler ultrasound and MSCT have certain diagnostic value for Todani classification of children with CCC, and the combination of the two methods has higher diagnostic value.