多层螺旋CT多平面重建在急性阑尾炎诊断中的应用

Application of Multiplanar Reconstruction with MSCT to Diagnosis of Acute Appendicitis

目的探讨多层螺旋CT(MSCT)多平面重建(MPR)技术在急性阑尾炎诊断中的应用价值。方法对42例疑诊急性阑尾炎患者行全腹部MSCT扫描,回盲部薄扫,经工作站后处理获得回盲部MPR像。比较仅轴位像、轴位结合MPR像两种方法的诊断结果。结果对照手术病理,仅阅读轴位像诊断急性阑尾炎的敏感性82.86%,特异性28.57%,阳性预测值85.29%,阴性预测值25%,准确性73.81%;轴位结合MPR像诊断的敏感性94.23%,特异性57.14%,阳性预测值91.67%,阴性预测值66.67%,准确性88.10%。结论 MSCT应用MPR技术能够将阑尾基部、回肠末端及盲肠显示在同一平面图像上,对阑尾空间关系的把握和细节的观察更具优势,提高了临床疑诊急性阑尾炎患者的术前诊断能力。

Objective To explore the clinical application value of multiplanar reconstruction（MPR）with multislice spiral CT（MSCT）in the diagnosis of acute appendicitis.Methods 42 patients with clinical suspected acute appendicitis was taken whole abdomen scanning with MSCT,thin layer scanning in ileocecal junction.The data was dealt by workstation and MPR image of ileocecal junction can be obtained.Then to compare the diagnosis results obtained from axial images and axial combined with MPR images.Results Compared with operation and pathology,the diagnosis results of acute appendicitis obtained by reading axial images had a sensitivity of 82.86%,specificity of 28.57%,positive predictive value of 85.29%,negative predictive value of 25% and accuracy of 73.81% respectively.Results obtained from axial and MPR images had a sensitivity of 94.23%,specificity of 57.14%,positive predictive value of 91.67%,and negative predictive value of 66.67% and accuracy of 88.10% respectively.Conclusion Base of appendix,terminal ileum and cecum could be displayed in the same plane by the use of MPR with MSCT.It had advantage in observing the spatial relation and details of appendix,and significantly improved the ability of preoperative diagnosis of clinical suspected acute appendicitis.