摘要
目的:探讨基层医院高频超声及X线诊断婴儿发育性髋关节发育不良(DDH)的应用价值。方法:选择本院确诊为DDH的患儿共35例(58髋)。对比分析患儿的超声与X线检查的一致性,统计分析独立使用α角、β角以及综合Graf法结果诊断DDH的敏感度、特异度、符合率、阳性预测值、阴性预测值。结果:X线检查诊断为DDH的符合率为72.2%,比超声检查的86.1%低,但差异无统计学意义(χ2=2.105,P=0.147);但两者联合诊断DDH的符合率达100%,较X线或超声单独诊断均高。X线和超声检查结果的kappa值为0.794,可见两种检查结果基本一致。超声Graf法诊断DDH的敏感度、特异度、符合率、阳性预测值和阴性预测值分别为86.1%、100%、91.7%、100%、82.8%,而用超声Graf法测量的α角和β角独立诊断DDH的敏感度、特异度、符合率、阳性预测值和阴性预测值分别为83.3%、100%、90.0%、100%、80.0%和77.8%、100%、86.7%、100%、75.0%。结论:对于婴儿DDH的诊断符合率,超声检查较X线高,而两者联合应用可达100%。两项检查各有特点,需要临床医师结合婴儿及设备等情况合理选择。
Objective：The purpose of this report was to investigate the application values of high-frequency ultrasound and X-ray in the diagnosis of infantile developmental dysplasia of the hip（DDH）at primary hospitals.Methods：Thirty-five children diagnosed as DDH（58hips）were selected at our hospital.The diagnostic consistency of ultrasound with X-ray was statistically analyzed with their sensitivity,specificity,accuracy,positive predictive value,negative predictive value of using independentlyαangle,βangle and integrated Graf method.Results：The coincidence rate of X-ray was 72.2%,which was lower than 86.1% of ultrasound without significant difference（χ2=2.105,P=0.147）.However,our data showed the combined coincidence rate of the two examinations was 100%,higher than X-ray or ultrasound alone.The kappa value was0.794 by use of X-ray and ultrasound separately,which showed the two approaches were basically consistent.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value by use of Graf ultrasound method were86.1%,100%,91.7%,100%,82.8%,respectively.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value by use ofαangle andβangle of Graf ultrasound method were 83.3%,100%,90.0%,100%,80.0%and 77.8%,100%,86.7%,100%,75.0%,respectively.Conclusions：The diagnostic accuracy of infant DDH using ultrasound is higher than that of using X-ray,which can reach 100% with combination of both.Ultrasound and X-ray have different characteristics,physicians need to make a reasonable choice by taking particular case and equipment features into considerations.
出处
《放射学实践》
北大核心
2015年第7期783-786,共4页
Radiologic Practice
基金
佛山市医学类科技攻关项目(201308297)
