急性阑尾炎的多层螺旋CT表现与病理对照

Comparison of Multi-slice spiral CT manifestations of acute appendicitis with pathological findings

目的:对比研究急性阑尾炎多层螺旋CT特征与术后病理结果。方法:回顾性分析37例临床表现不典型的急性阑尾炎患者及其他疾病临床表现类似急性阑尾炎患者的CT检查资料,术前所有患者均作了常规CT扫描和三维重建检查,其中9例,做增强CT扫描。结果:对照手术病理,CT平扫、增强及三维重建诊断急性阑尾炎敏感性92.6%,特异性70%,准确性86.5%,阳性预测值89.3%,阴性预测值77.8%。增强后可以发现回结肠动脉周围肿大的淋巴结。结论:多层螺旋CT平扫、增强及三维重建的应用,可以对急性阑尾炎的不同类型及病程进展做出正确判断。

Objective：To compare multi-slice spiral CT features of acute appendicitis with postoperative pathologiccal results.Methods：CT data of 37 patients with atypical clinical manifestations of acute appendicitis and other diseases with similar clinical manifestations of acute appendicitis were in retrospectively analyzed.Prior to operation,all patients underwent routine CT scan and three dimensional reconstruction,in which 9 cases were subjected to enhaned CT scan.Results：Compared with postoperative pathological results,the sensitivity,specificity,veracity,positive predicitive value,and negative predictive value was 92.6%,70%,86.5%,89.3%,and 77.8% respectively by the combination of routine CT scan,enhanced CT scan and three dimensional reconstruction.In particular,the enhaned CT scan can find the enlarged lymph nodes around back colic artery.Conclusion：The applications of Multi-slice spiral CT scan,enhanced CT and three-dimensional reconstruction of that can make the right judgments for different types of acute appendicitis and their progression.