探讨高频超声联合彩色多普勒超声评估肠套叠患儿肠壁血流状态的价值及其对灌肠复位成功率的预测效能。

采用回顾性分析方法，收集2022年1月至2024年12月西北妇女儿童医院收治的293例急性肠套叠患儿临床资料，其中复位成功组259例，复位失败组34例。所有患儿入院2 h内完成高频超声检查，定量测量同心圆直径、套鞘直径及套筒征长度，定性观察同心圆征、假肾形征及积液；同步采用彩色多普勒超声按改良Rubin标准分级评估肠壁血流状态。患儿均接受超声引导下空气灌肠复位治疗。比较两组超声指标差异，通过受试者工作特征曲线分析（ROC）单一及联合诊断对复位失败的预测价值。

复位失败组患儿的同心圆直径、套鞘直径及套筒征长度均显著大于复位成功组（P<0.001）。复位失败组假肾形征（85.29%比16.60%）和腹腔积液（44.12%比6.18%）的发生率显著高于复位成功组，而同心圆征的出现率则显著低于复位成功组（76.47%比96.91%，均P<0.001）。复位成功组绝大多数患儿（73.36%）表现为0级血流，复位失败组中II~IV级血流信号的比例显著高于复位成功组（P<0.001）。高频超声联合彩色多普勒超声在预测复位失败方面表现出优异的诊断效能。联合诊断的敏感度（94.12%）、特异度（97.68%）及约登指数（0.918）均高于单一高频超声或单一彩色多普勒超声。ROC曲线分析证实，联合诊断的曲线下面积（AUC=0.962）显著大于单一高频超声（AUC=0.875）或单一彩色多普勒超声（AUC=0.884）（P<0.05）。

高频超声联合彩色多普勒超声通过量化肠壁形态学特征与血流状态，对肠套叠灌肠复位成功率具有重要评估价值，可为临床预后预判提供可靠影像学依据。

To explore the value of high-frequency ultrasound combined with color Doppler ultrasound in evaluating the blood flow state of intestinal wall in children with intussusception and its predictive effect on the success rate of enema reduction.

A retrospective analysis was conducted to collect clinical data of 293 children with acute intussusception admitted to Northwest Women's and Children's Hospital from January 2022 to December 2024, among them, there were 259 cases in the successful reduction group and 34 cases in the failed reduction group. All patients completed high-frequency ultrasound examination within 2 hours of admission. The concentric circle diameter, sheath diameter, and sleeve sign length were quantitatively measured, and the concentric circle sign, pseudorenal sign, and fluid accumulation were qualitatively observed. The color Doppler ultrasound was simultaneously used to evaluate the intestinal wall blood flow status according to the modified Rubin grading system. All patients received ultrasound-guided air enema reduction treatment. The differences in ultrasound indicators between two groups were compared and the predictive value of single and combined diagnosis for reset failure was analyzed through receiver operating characteristic (ROC) curve.

The concentric circle diameter, sheath diameter, and sleeve sign length in the reduction failure group were significantly greater than those in the reduction success group (P<0.001). The incidences of pseudorenal sign (85.29% vs. 16.60%) and ascites (44.12% vs. 6.18%) in the reduction failure group were significantly higher than those in the reduction success group, while the incidence of concentric circle sign was significantly lower (76.47% vs. 96.91%, P<0.001). The vast majority of children in the reduction success group (73.36%) presented with grade 0 blood flow, whereas the proportions of grade Ⅱ-Ⅳ blood flow signals in the reduction failure group were significantly higher than those in the reduction success group (P<0.001). High-frequency ultrasound combined with color Doppler ultrasound demonstrated excellent diagnostic performance in predicting reduction failure. The sensitivity (94.12%), specificity (97.68%), and Youden index (0.918) of the combined diagnosis were higher than those of high-frequency ultrasound alone or color Doppler ultrasound alone. ROC curve analysis further confirmed that the area under the curve (AUC) of the combined diagnosis (0.962) was significantly greater than that of high-frequency ultrasound alone (0.875) or color Doppler ultrasound alone (0.884) (P<0.05).

High-frequency ultrasound combined with color Doppler ultrasound has important evaluation value for the success rate of intussusception enema reduction by quantifying the morphological characteristics and blood flow state of intestinal wall, and can provide reliable imaging basis for clinical prognosis prediction.