高频彩色多普勒超声诊断急性阑尾炎的价值

The Value of High-frequency Color Doppler Ultrasonography in the Diagnosis of Acute Appendicitis

目的探讨阑尾炎的高频及彩色多普勒超声表现特征。方法回顾分析总结280例急性阑尾炎的声像图特征及血流特点,总结其与病理类型的关系。结果 280例病例中,单纯阑尾炎89例,表现为右下腹形态固定的盲管样结构,管壁层次清楚,周围肠管可轻度扩张,周围无明显积液征象,管壁见血流信号;急性化脓性阑尾炎137例,表现为形态固定的盲管样结构,管壁轻度水肿增厚,层次清晰,粘膜、浆膜层水肿增厚明显,毛糙。盲管周围少量积液,周围肠管明显扩张,可见有大网膜包绕,管壁血流信号较丰富;坏疽及穿孔者54例,表现为仅显示小的不规则盲管样结构,周围为不规则低回声,周边肠管明显扩张、包绕,大网膜包绕,管壁无血流信号。合并右下腹淋巴结肿大者270例。合并回盲部肿瘤2例。合并回盲部慢性炎症5例。合并腹腔结核4例。结论高频、低频及彩色多普勒超声联合应用可提高急性阑尾炎的超声诊断符合率并准确判断其病理类型,指导临床及时恰当的选择治疗方案。

Objective To explore the high-frequency color Doppler uhrasonographic features of acute appendicitis. Methods A retrospective study of 280 cases with acute appendicitis was made to summarize its high-frequency uhrasonographic and color Doppler characteristics, and analysize its relationship with pathology. Results Simple appendicitis189 case } shows a fixed blind tube-like structure in the right lower quadrant, with clear wall hierarchy （ few blood flow signal inside } and mild dilatate loops around, without obvious effusion around; acute suppurative appendicitis1137 cases} shows a fixed blind tube-like structure with mild wall edema and thickening（abundant blood flow signal inside） , especially the mucosal and serous layer, and obvious dilatate loops and omental wrap- ping around ; gangrene and perforation （ 54 eases ） shows small blind tube- like structure （ no blood flow signal inside } with obvious dilatate loops and omental wrapping around. Among the 280 cases,270 cases with swelling lymph nodes ,2 cases with complicated ileocecal tumor,5 cases with complicated ileocecal chronic inflammation,4 cases with abdominal tuberculosis. Conclusion High-frequency color Doppler uhrasonography could improve the diagnosis of acute appendicitis and indicate the pathological type. [