CT平扫对症状不典型急性阑尾炎的诊断价值

The Diagnostic Value of Nonenhanced CT for Acute Appendicitis Without Classic Signs and Symptoms

目的探讨CT平扫对症状不典型急性阑尾炎的诊断价值。方法对21例经手术及病理证实的症状不典型急性阑尾炎病例的术前CT资料进行回顾性分析。结果 21例均有不同程度的急性阑尾炎CT表现,其中,14例见阑尾增粗,16例有右下腹或盆腔炎性改变(如脂肪线增粗、肠周积液、脓肿等),8例有阑尾结石,2例见盲肠末端有局限性增厚。结论腹部CT平扫对诊断症状不典型急性阑尾炎很有帮助;腹部CT平扫检查时,应将急性阑尾炎作为重要疾病加以排除。

Objective To discuss the diagnostic value of nonenhanced CT in acute appendicitis with atypical presentations.Methods CT data of 21 cases of acute appendicitis proved by surgery and pathology without typical clinical manifestation were analyzed retrospectively.Results All 21 cases had the CT findings of acute appendicitis.There were enlarged appendix in 14 cases,signs of inflammation of right lower quadrant or localized abscess in pelvis in 16 cases（such as fat line thickeningf,luid collection around bowels or abscess）,blocks of stercorolith in 8 cases,localized thickening of wall of cecal apex in 2 cases.Conclusions Nonenhanced CT is useful to surgeons in making correct diagnosis of acute appendicitis without typical symptoms.Acute appendicitis should be kept in mind of radiologist to be excluded when nonenhanced abdominal CT is performed.