声学密度定量技术在诊断急性期非典型川崎病中应用.docVIP

声学密度定量技术在诊断急性期非典型川崎病中应用 　 作者：陈湘,杨华彬,关凤军,王成,王秀英 【关键词】 声学密度定量技术；影像诊断学；川崎病 　　［摘 要］ 目的：探讨声学密度定量技术在诊断急性期非典型川崎病中的临床意义。方法：研究对象分3组：典型川崎病组34例(A组)，非典型川崎病组31例(B组)，正常对照组30例。应用HP5500型超声诊断仪测定左、右冠状动脉壁背向散射积分 (IBS)，以心包壁的IBS作为参照，用冠脉壁IBS和心包IBS比值作为校正值(IBS%)。结果：A组和B组的冠脉壁IBS值、IBS%值差异无显著性（Pgt;0.05）；A组和B组的冠脉壁IBS值、IBS%值均显著大于正常对照组（Plt;0.01），对冠脉壁IBS进行ROC分析，得到冠脉壁IBS最佳截点为41.5，据其诊断急性期川崎病的敏感性为93%，特异性为95%，准确性为94%。结论：声学密度定量技术有助于急性期川崎病的诊断，尤其对临床表现和冠脉病变不典型川崎病的诊断有重要价值。 　　［关键词］ 声学密度定量技术；影像诊断学；川崎病 　　Acoustic Densitometory Is Instrumental in Diagnosing Untypical Kawasaki Disease of Acute stage 　　Abstract:Objective To probe into the clinical significance of applying acoustic densitometry to diagnosis untypical Kawasaki Disease of acute stage.Methods Subjects were assigned into three groups:34 cases of typical KD(group A),31 cases of untypical KD(group B) and 30 cases of healthy children being as control.HP5500 type ultrasonoscope was used to detect integrated backscatter(IBS) of both left and right coronary artery walls with IBS of pericardial wall as referance,while ratio of coronary artery walls IBS to epicardium one as correction value(IBS%).Results No notable difference on IBS of coronary artery walls was found between Group A and B,and neither IBS%(Pgt;0.05);coronary artery walls IBS and IBS% value of group A and B were all higher than that of control according to statistics(Plt;0.01),An analysis of ROC on coronary artery walls was then performedto find a optimum cutpoint of coronary artery walls IBS,41.5,and on the base of which we can diagnosis Kawasaki Disease of acute stage with the sensitivity being 93%,specificity 95% and accuracy 94% respectively.Conclusion The diagnosis of Kawasaki disease on acute stage will benefit from acoustic densitometory,which has extraordinary value on diagnosis of those without typical clinical manifestation and coronary disease. 　　Key words:Acoustic densitometory;Image diagnostics;Kawasaki disease 　　 　　近年来不典型的川崎病增多，临床诊断中对冠状动脉病变的客观依据依赖度增加。然而，在川崎病早期冠状动脉病变的影像改变可不典型，常规超声