急性阑尾炎超声影像特征分析

Analysis on ultrasonic image features of acute appendicitis

目的 总结急性阑尾炎超声表现,探讨超声图像特征对急性阑尾炎及其病因的诊断价值.方法 回顾性分析70例临床手术确诊的急性阑尾炎患者阑尾超声声像图特征.结果 本组70例患者中,有明确病因的27例（38.6％）,均为粪石阻塞.60例（85.7％）超声检查阑尾及其周围示明显改变.阑尾改变包括形态改变、管壁厚度改变、管壁回声改变、管腔内容物.阑尾外周改变包括回盲部水肿、胃肠道积气积液扩张、外周肠间隙积液、阑尾周围强回声组织包绕、小网膜囊积液、盆腔积液、门静脉栓子.结论 急性阑尾炎超声诊断符合率高,对粪石阻塞引起的阑尾炎有很高的诊断价值.超声对急性阑尾炎的分型诊断有重要作用,可为临床进一步治疗提供依据.

Objective To summarize the ultrasonic characteristics of acute appendicitis and the value of uhrasonog raphy in the diagnosis of acute appendicitis and to discuss the causes of acute appendicitis. Methods The sonograms of 70 cases who had been comfirmed as acute appendicitis and underwent operations were retrospectively analyzed. Results In the 70 cases, the causes of acute appendicitis had been identified in 27 cases （38.6%） , which were stercoral ob struction. Uhrasonography showed that 60 cases （85.7%） had obvious changes in the appendix and its surrounding tis sue. The ultrasonographic changes of the appendix included morphological changes, changes of wall thickness, echoes of the appendix wall, and abnormal contents in the appendix. The uhrasonographic changes of appendix peripheral fissured include ileocecal edema, gastrointestinal gas effusion expansion and peri intestinal interstitial effusion, strong echo tis sue around the appendix, the lesser omental bursa effusion, pelvic effusion, and portal vein embolism. Conclusion U1 trasonography has high diagnostic coincidence rate for acute appendicitis and can play an important role in the diagnosis of the stercoral obstruction. Ultrasonography is very importantclassification diagnosis of acute appendicitis and can be a guide to clinical treatment.