32层螺旋CT三维重组在急性阑尾炎诊断及鉴别诊断中的价值

Clinical application of 3D reformation technique with 32-slice spiral CT in the diagnosis and differential diagnosis of acute appendicitis

目的:探讨32层螺旋CT三维重组诊断急性阑尾炎的临床应用。方法:搜集60例临床拟诊急性阑尾炎的病例,采用32层螺旋CT进行扫描,以1.25mm层厚行薄层多平面容积重组图像后处理,总结分析其CT表现,并将诊断结果与手术及病理结果进行对照。结果:60例患者中,诊断为急性阑尾炎54例,右侧腹股沟疝1例,右侧输尿管下段结石1例,胆囊炎1例,结肠肿瘤1例,假阴性2例。其中CT表现为阑尾水肿、增粗、管壁增厚者52例,阑尾腔内肠石10例,阑尾周围炎45例,回盲部壁增厚12例,阑尾脓肿2例,阑尾穿孔2例,其中1例并发腹膜炎及麻痹性小肠梗阻。结论:急性阑尾炎有典型的CT表现,32层螺旋CT三维重组及图像后处理技术能从不同角度显示阑尾及其周围情况,在急性阑尾炎的诊断和鉴别诊断中,有较高的临床应用价值。

Objective：To investigate the clinical application of 3D reformation technique with 32-slice spiral CT in the diagnosis of acute appendicitis.Methods：60 patients with clinical suspected acute appendicitis were enrolled in this study.32-slice spiral CT was used with slice thickness as 1.25mm and post processing technique of multi-planar reformation was performed.The CT images were retrospectively analyzed and correlated with surgery and pathology findings.Results：Of the 60 patients,there were acute appendicitis in 54 patients,right inguinal hernia,calculi within distal segment of right ureter,cholecystitis,colon tumor in 1 patient for each;2 patients were false-negative.The CT findings of acute appendicitis included edema,enlargement,thickening of the wall of appendix in 52 cases,appendicolith in 10 cases,peri-appendiceal inflammation in 45 cases,thickening of ileao-cecal wall in 12 cases,appendiceal abscess in 2 cases,perforation of appendix in 2 cases,in which 1 case was complicated with peritonitis and paralytic ileus.Conclusion：Characteristic CT findings could be assessed in acute appendicitis,images of appendix at various angles as well as the peri-appendiceal changes could be displayed on 3D reformation images with 32-slice spiral CT,which provided significant information in the diagnosis and differential diagnosis of acute appendicitis.