超声对儿童脐息肉与脐肉芽肿的鉴别诊断价值

目的 探讨超声对儿童脐息肉与脐肉芽肿的鉴别诊断价值。 方法 收集2013年7月-2021年5月在我院及无锡市儿童医院经病理确诊的24例儿童脐息肉患者（脐息肉组）和40例脐肉芽肿患者（脐肉芽肿组）的临床及超声资料，对比分析两组超声特征差异，并权重各种超声表现的诊断优势比（OR）建立联合诊断方程，采用ROC曲线评估鉴别诊断效能。 结果 脐息肉组与脐肉芽肿组在患者年龄和性别方面差异均有统计学意义（P＜0.05）。单因素分析显示，脐息肉组和脐肉芽肿组的超声特征在病灶深度、病灶血供及脐口下方窦道方面差异有统计学意义（P均＜0.05），鉴别诊断效能以AUC表示：病灶深度深：0.694（95%CI:0.560～0.829）;病灶血供呈乏血供或无血供：0.762（95%CI:0.635～0.889）及脐口下方窦道存在：0.699（95%CI:0.556～0.843）。多因素分析显示， 病灶深度、病灶血供及脐口下方窦道方面得到的回归系数有统计学意义，采用综合多因素的联合诊断方程，ROC曲线下AUC为0.873（95%CI:0.769～0.977，P=0.001），其鉴别诊断脐息肉的敏感性和特异性分别为84.6%（95%CI:67.5%～93.0%）和87.2%（95%CI:78.6%～95.2%），鉴别诊断效能优于单一因素（P=0.018、0.038、0.002）. 结论 儿童脐息肉与脐肉芽肿的超声声像图特征具有一定的特异性，采用联合诊断可进一步改善鉴别诊断效能。

Differential diagnosis between umbilical polyp and umbilical granuloma in children by ultrasonography

Objective To investigate the value of ultrasonography in differentiating umbilical polyps from umbilical granuloma in children. Methods The clinical and ultrasonographic data of 24 children with umbilical polyps (umbilical polyps group) and 40 patients with umbilical granuloma (umbilical granuloma group) who were pathologically diagnosed in our hospital and Wuxi Children''s Hospital from July 2013 to May 2021 were collected, the differences in ultrasonographic characteristics between the two groups were compared and analyzed, the diagnostic odds ratio (OR) of various ultrasonographic findings was weighted to establish a combined diagnostic equation, and ROC curve was used to assess the differential diagnostic efficacy.Results There were significant differences in age and sex between patients with umbilical polyp and umbilical granuloma (P < 0.05). Univariate analysis showed that there were significant differences in the ultrasonographic characteristics of the umbilical polyp umbilical granuloma group in terms of lesion depth, lesion and sinus tract below the umbilicus (P < 0.05), and the differential diagnostic efficacy was expressed as AUC: deep lesion depth: 0.694 (95% CI: 0.560 to 0.829); poor or absent lesion: 0.762 (95% CI: 0.635 to 0.889) and the presence of sinus tract below the umbilicus: 0.699 (95% CI: 0.556 to 0.843). Multivariate analysis showed that the regression coefficients obtained in terms of lesion depth, lesion and sinus tract below the umbilicus were statistically significant. Using the combined diagnostic equation of comprehensive multiple factors, the AUC under ROC curve was 0.873 (95% CI: 0.769 ~ 0.977, P = 0.001), the sensitivity and specificity of differential diagnosis of umbilical polyps were 84.6% (95% CI: 67.5% ~ 93.0%) and 87.2% (95% CI: 78.6% ~ 95.2%), respectively, and the differential diagnostic efficacy was superior to that of single factor (P = 0.018, 0.038, 0.002).Conclusion The ultrasonographic features of umbilical polyps and umbilical granulomas in children have certain specificity, and the combined diagnosis can further improve the efficacy of differential diagnosis.