重视正常阑尾CT影像对鉴别急性阑尾炎的价值

CT appearances of the normal appendix in identification of acute appendicitis

目的:重视正常阑尾的CT影像表现,减少对急性阑尾炎的漏诊、误诊。方法:收集我院2010-09-2011-06行全腹部CT 287例寻找正常阑尾,并进行MPR图像重建,同时收集我院经手术病理证实为急性阑尾炎18例,并进行回顾分析。结果:①287例中有261例可发现正常阑尾(90.9%)。②急性阑尾炎18例,术前CT误诊10例:其中单纯急性阑尾炎1例漏诊,误诊为回盲部肿瘤4例、小肠肿瘤3例、右下腹附件炎性肿块2例。通过回顾分析误诊主要原因是未能充分认识正常阑尾影像表现。结论:多排螺旋CT显示阑尾率高,掌握正常阑尾影像表现,有助于提高急性阑尾炎的诊断。

Objective：The CT appearance of normal appendix should he pay attention to in order to reduce the misdiagnosis of acute appendicitis. Methud：The whole abdominal CT of 287 patients were collected from September 2010 to June 2011 and the normal appendix signs were analyzed. At the same time, 18 patients with acute appendi-citis confirmed by surgery and pathology were analyzed retrospectively. Result： The normal appendix was clearly visualized in CT scans of 261 cases in 287 patients（90. 9%）. Among 18 patients with acute appendicitis, ten pa-tients were misdiagnosed before surgery： four patients were diagnosed as caecum tumor,three patients were diag nosed as intestinal tumor, two patients were diagnosed as annex inflammatory mass, and there was one case of missed diagnosis. The main reason for misdiagnosis is inadequate recognition of the CT signs of normal appendix, Conclusion：The rate of norrnal appendix showing is high in multi slice spiral CT scans. Master the normal appendix imaging performance was helpful to improve the diagnosis of acute appendicitis.