多排螺旋CT与超声检查诊断急性阑尾炎的对比分析
冯战国
（陕西省乾县人民医院CT 室，陕西 宝鸡，713300）
浏览次数：119次 下载次数：360次
摘要：
目的 讨论多排螺旋CT与超声检查对急性阑尾炎的诊断价值。方法 将我院2011―2015年收治的急性阑尾炎患者70例分别以超声及多排螺旋CT进行检测，并将检测结果与术后病理结果相比较，分析其诊断价值。结果 CT诊断表现：可见阑尾肿大、增粗情况，同时可见蜂窝织炎改变，并有坏疽、穿孔出现。超声诊断表现：可见阑尾轻度肿胀，管壁依次可见黏膜层，黏膜下层，基层及浆膜层，层结构界限清楚，阑尾可见囊袋样改变，有积液出现，回声不均匀。坏疽性阑尾可见阑尾显著增大， 轮廓模糊，层黏膜结构消失，阑尾周边可见，液性暗区。70例经术后病理证实的阑尾炎患者，在CT图像上正确诊断61例，诊 断准确率为87.1%（[53+8）/72]；超声图像正确诊断54例，诊断准确率为77.1%（[49+5）/72]，多排螺旋CT检查诊断准确率高于超声检查，差异具有统计学意义（X2=9.4678，P<0.01）。结论 多排螺旋CT在诊断急性阑尾炎时具有较高的准确率。
关键词：多排螺旋CT；超声；急性阑尾炎
中图分类号：R656.8文献标志码：A文章编号：2096-1413(2016)26-0135-02
Comparative analysis in diagnosis of acute appendicitis between multi-slice CT and ultrasound
FENG Zhan-guo
(Department of CT Room, Qianxian People`s Hospital in Shaanxi Province, Xianyang 713300, China)
ABSTRACT: Objective To explore the clinical diagnosis value of multi -slice CT and ultrasound on acute appendicitis. Methods Seventy cases of patients with acute appendicitis in our hospital from 2011 to 2015 were selected as research objects. The patients were respectively used multi-slice CT and ultrasound to diagnose the acute appendicitis, then the testing results and postoperative pathological results were compared. Results CT manifestated the swollen appendix, enlargement and cellulitis changes, it showed the gangrene and perforation at the same time. Ultrasonic diagnostic performance showed mild swelling. The appendix wall contained mucous membrane layer, submucosa, grassroots and serous membrane layer; the boundary layer structure was clear. The appendix had pouch sample change and with effusion and uneven echo. The gangrenous appendicitis showed that the appendix enlarged significantly, the outline was hazy, mucous membrane layer disappeared, the peripheral appendix was clear and with liquid dark space. Seventy cases of appendicitis patients confirmed by postoperative pathology, the correct diagnosis on CT images were 61 cases, the diagnostic accuracy rate was 87.1%[(53+ 8)/70]; while the correct diagnosis on ultrasound images were 54 cases, the diagnostic accuracy rate was 77.1%[(49+5)/70], and the diagnostic accuracy rate of CT was higher than that of ultrasound, there was significant difference between two methods ( X2=9.4678, P<0.01). Conclusion There was higher accuracy rate of multi-slice CT in diagnosis of acute appendicitis.
KEYWORDS: multi-slice CT; ultrasound; acute appendicitis
参考文献：
[1] BRINBAUM B,AWILSON SR.Appendicitis at the millennium [J]. Radiology,2002,215(2):337-348.
[2] 姚永刚,杜静波,苏建伟,等.急性阑尾炎穿孔的CT诊断及图像特征分析[J].中国体视学与图像分析,2014,13(4):348-353.
[3] 么恩亮,张秀虹,王瑞娟.多层螺旋CT在诊断急性阑尾炎中的价值 [J].实用放射学杂志,2008,24(9):1221-1223.
[4] 胡利国,柴小青,方才,等.全身麻醉和硬膜外麻醉行剖宫产术对产妇和新生儿的影响[J].皖南医学院学报,2009,28(4):296-298.
[5] 吴霞,韩传宝,蒋秀红.右美托咪定用于防治剖宫产术中寒战反应的适宜剂量[J].临床麻醉学杂志,2014,30(12):1211-1213.
[6] 陈梁,曾宇.两种局部麻醉药用于臂丛神经阻滞后寒战观察[J].实用医学杂志,2011,27(2):344-345.
[7] 郑庆国.氯普鲁卡因与碳酸利多卡因用于剖宫产术的临床比较[J]. 海南医学,2009,20(7):230-232.
[8] 薛瑞萍,温来友,吴震.碳酸利多卡因在无痛分娩失败改剖宫产术 中的应用[J].临床和实验医学杂志,2011,10(22):1779-1780.
[9] 乔洪波.多层螺旋CT 联合高频超声对急性阑尾炎诊断与术后病 理对照准确性及影像学特征研究[J].中国医师进修杂志,2012,35(12):63-64.