CT平扫在急、慢性阑尾炎中的诊断价值

Value of Plain CT Scanning in the Diagnosis of Acute and Chronic Appendicitis

【目的】探讨CT平扫在急、慢性阑尾炎中的诊断价值。【方法】回顾性分析28例临床可疑急、慢性阑尾炎并经CT平扫检查患者资料，分析其诊断准确率、特异性与敏感性等。【结果]CT检查示28例患者中有24例诊断为急、慢性阑尾炎，与病理对照漏诊4例急性阑尾炎，误诊2例，其中1例附件囊肿cT诊断为阑尾脓肿，1例小肠管壁增粗CT诊断为急性阑尾炎，敏感性为85％（22／26），特异性为50％（1／z），准确性为82％（23／28），阳性预测值为92％（22／24），阴性预测值为25％（1／4）。CT平扫分级与病理分级Kappa：0．0625。【结论】CT平扫诊断急、慢性阑尾炎敏感性、准确性较好，特异性及阴性预测值较低，提示CT平扫对于发现急、慢性阑尾炎是一种较好的手段，但对于急、慢性阑尾炎分级作用较差。

[Objective] To explore the value of plain CT scanning in the diagnosis ot acute and chronic ap- pendicitis. [Methods] The data of plain CT scanning of 28 patients with clinically suspected acute and chronic appendicitis were analyzed retrospectively. The diagnostic accuracy, sensitivity and specificity were analyzed. [Results] CT scanning showed that 24 patients of 28 patients were diagnosed as acute and chronic appendici- tis. Compared with the pathological examination, the diagnosis of 4 patients with acute appendicitis was missed, and 2 patients were misdiagnosed. One patient with adnexal cyst was diagnosed as appendiceal abscess by CT. One patient with enlargement of intestinal canal wall was diagnosed as acute appendicitis by CT. The sensitivity, specificity and accuracy were 85%（22/26）, 50% （1/2） and 82~//00 （23/28）, respectively. The posi- tive and negative predictive value were 92 % （22/24） and 25 ~ （1/4）, respectively. The Kappa value between plain CT and pathology grading was 0. 0625. [Conclusion]Plain CT scanning is highly accurate and sensitive in diagnosing acute and chronic appendicitis. The specificity and negative predictive value are lower. It indicates that plain CT scanning is a better way to diagnose acute and chronic appendicitis. Plain CT scanning is not much good for the grading of acute and chronic appendicitis.