摘要
目的评价在急性阑尾炎诊断中应用16排螺旋CT的临床应用价值。方法研究时段为2016年1月～2018年6月,研究目标为研究时段内本院收治的332例急性阑尾炎患者,332例患者均经手术病理诊断,在手术病理诊断前,均给予16排螺旋CT检查,分析16排螺旋CT在急性阑尾炎诊断中的符合率、敏感度、特异度及其影像学特征。结果 332例患者经手术病理诊断,确诊者321例,病理诊断为其他者11例;321例中单纯性、化脓性、坏疽性及穿孔性阑尾炎分别为28例、180例、91例,22例阑尾周围脓肿。16排螺旋CT检查后,确诊为急性阑尾炎者319例,病理诊断其他者13例,319例中单纯性、化脓性、坏疽性及穿孔性阑尾炎分别为28例、179例、90例,22例阑尾周围脓肿。诊断符合率相比,手术病理诊断与16排螺旋CT差异无统计学意义(P> 0.05)。敏感度为99.37%(319/321)、特异度为84.61%(11/13)。CT影像学表现:单纯性:阑尾增粗、增大,且直径超过6mm,管壁增厚,增粗阑尾部分边缘不清,且其周边组织与脂肪密度增高。化脓性:阑尾周边、盲肠系膜的脂肪密度不均匀,可见高密度影,回肠壁、盲肠顶端增厚,淋巴结增大,周围或盆腔有积液。坏疽性及穿孔性:阑尾管壁出现损伤,边界不清,腔外可见粪石、积气。结论在急性阑尾炎诊断中应用16排螺旋CT可对病灶类型进行准确判断,临床诊断效果显著,可为治疗方案的制定提供参考依据,临床应用价值较高,值得推广。
Objective To evaluate the clinical value of 16-slice spiral CT in the diagnosis of acute appendicitis. Methods 332 patients with acute appendicitis admitted to our hospital during January 2016 to June 2018 was collected as subjects. All the 332 patients were diagnosed by surgical pathology, and 16-slice spiral CT examination was performed before surgical pathology diagnosis. The coincidence rate, sensitivity, specificity and imaging characteristics of 16-slice spiral CT in the diagnosis of acute appendicitis were analyzed. Results 332 patients who underwent surgical pathology diagnosis, 321 cases were confirmed and 11 cases were pathologically diagnosed. There were 28 cases of simple appendicitis, 180 cases of pyogenic appendicitis, 91 cases of gangrene appendicitis and 22 cases of periappendiceal abscess. After 16-slice spiral CT examination, 319 cases were diagnosed as acute appendicitis, and 13 cases were pathologically diagnosed as other cases. 319 cases included simple appendicitis, suppurative appendicitis, gangrene and perforated appendicitis (28 cases, 179 cases, 90 cases and 22 cases of periappendiceal abscess, respectively). Compared with the diagnostic coincidence rate, there was no significant difference between surgical pathological diagnosis and 16-slice spiral CT (P > 0.05). Sensitivity was 99.37%(319/321) and specificity was 84.61%(11/13). CT imaging findings: simple: appendix thickened and enlarged, with a diameter of more than 6mm, tube wall thickened, thickened appendix part edge was not clear, and the surrounding tissue and fat density increased. Suppurative: the fat density of peripheral and blind mesentery were not uniform, high density shadow could be seen, thickened back to the intestinal wall and cecal top, lymph nodes were enlarged, and the surrounding or pelvic cavity was filled with liquid. Gangrene and perforation: the wall of the appendix was damaged, the boundary was not clear, and there were bezoar and gas outside the cavity. Conclusion 16-slice spiral CT can be used to accurately determine the type of lesion in the diagnosis of acute appendicitis. The clinical diagnosis is significant, which can provide reference for the development of treatment plan. The clinical application value is high and worth promoting.
作者
张旗松
李宏
任家庚
吴礼胜
柴洪波
白英连
ZHANG Qisong;LI Hong;REN Jiageng;WU Lisheng;CHAI Hongbo;BAI Yinglian(Imaging Department of Lianzhou People's Hospital in Guangdong Province, Lianzhou 513400, China)
出处
《中国医药科学》
2019年第3期121-124,共4页
China Medicine And Pharmacy
关键词
急性阑尾炎
16排螺旋CT
诊断符合率
影像学表现
Acute appendicitis
16-slice spiral CT
Diagnostic coincidence rate
Imaging findings
