BACKGROUND Ultrasonography (US) has been widely applied and has validated efficacy in the diagnosis of colonic polyps in children. However, little attention has been paid to improving the detection rate of polyps, optimizing the ultrasonic examination process and reducing misdiagnosis. OBJECTIVE To investigate the diagnostic performance of the colonic segment-approach by US in the diagnosis of colonic polyps in pediatric patients. MATERIALS AND METHODS One hundred fifty-nine patients who were going to have a colonoscopy from September 2014 to August 2016 were enrolled in this study. All patients received US before colonoscopy. In a preliminary study, 50 patients were chosen to determine the interobserver agreement, with half of the cases with and half of the cases without a colonic segment-approach. The other 109 patients were examined by both approaches. The sensitivity and the specificity of each approach were compared based on the outcome of colonoscopy as the gold criteria. RESULTS The interobserver agreement was high (0.816 for the non-segmental approach, 0.754 for the colonic segment-approach). The diagnostic sensitivity of the colonic segment-approach was higher than that of the traditional approach (82.1% vs. 57.7%, P<0.05) with 89.3% vs. 64.2% detection rate of colonic polyps in the descending colon, 81.8% vs. 60.6% in the sigmoid colon, and 81.3% vs. 43.8% in the rectum, respectively. The specificity of both methods was 100% (95% confidence interval: 86.3%-100%). CONCLUSION The US colonic segment-approach can improve diagnostic sensitivity for colonic polyps as a convenient method with no special requirement for equipment and examination conditions.

中文翻译：

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超声与结肠段治疗儿童结肠息肉的方法。

背景技术超声（US）已经被广泛应用并且已经证实了在诊断儿童结肠息肉中的功效。然而，很少有人关注提高息肉的检出率，优化超声检查过程并减少误诊。目的探讨超声对结肠段息肉的诊断对小儿结肠息肉的诊断价值。材料与方法从2014年9月至2016年8月对159例行结肠镜检查的患者进行了研究。所有患者均在结肠镜检查前接受US。在一项初步研究中，选择了50名患者来确定观察者之间的一致性，其中一半病例有结肠节段入路，一半病例没有结肠节段入路。两种方法均对其他109例患者进行了检查。基于结肠镜检查的结果作为金标准，比较了每种方法的敏感性和特异性。结果观察者之间的一致性很高（非分段方法为0.816，结肠段方法为0.754）。结肠节段法的诊断敏感性高于传统方法（82.1％vs. 57.7％，P <0.05），降级结肠息肉的检出率分别为89.3％vs. 64.2％，81.8％vs. 64.2％。在乙状结肠中分别占60.6％和81.3％，而在直肠中则为43.8％。两种方法的特异性均为100％（95％置信区间：86.3％-100％）。