低剂量CT在小儿急性阑尾炎中的应用

The Application Value of Low-dose CT in Diagnosing Acute Appendicitis for Children

目的应用低剂量CT探讨小儿急性阑尾炎的影像诊断价值。对象与方法2009年8月至2013年11月经低剂量CT扫描诊断为急性阑尾炎18例患儿,年龄1-13(6.48±4.00)岁;手术病理证实16例,保守治疗2例。结果 CT扫描参数:120KV,76-150(106.75±15.36)mA,CT辐射剂量指数(Computed tomography dose index,CTDI)为4.8-8.8(6.72±1.01)mGy;直接征象:阑尾增粗、肿大;继发征象:回盲区见粪石,周围结构显示不清,脂肪间隙昏暗,腹膜增厚,腹、盆腔积液;回盲区脓肿;邻近肠管壁增厚、肠腔扩张、积液;邻近淋巴结增大;腹腔积气伴门静脉积气。结论低剂量多层螺旋CT扫描不仅能很好显示小儿阑尾病变,而且能提示阑尾周围的脂肪密度、邻近肠管、腹膜、淋巴结、腹腔积液及游离气体等相关的间接征象。

Objective To explore value of the low-dose CT in diagnosing acute appendicitis for children. Methods From August 2009 to November 2013,18 children were diagnosed as acute appendicitis, The mean age was 6.48±4.00 years old （rang 1-13 years old）, 16 children with pathology confirmed, and 2 children with conservative treatment. Results The CT scan parameters： 120KV, 76-150（106.75±15.36）mA;CTDI： 4.8-8.8（6.72±1.01）mGy. Direct sign： thickened appendiceal diameter, thickened appendiceal wall, and distended appendiceal luminal diameter. Indirect signs： presence of periappendiceal inflammatory changes （fat stranding, fluid collection, phlegmon）, abscess formation, adjacent bowel wall thickening, adjacent adenopathy, and extraluminal air. Conclusion The characteristics of acute appendicitis can be clearly shown by Low-dose CT. It does not only indicate the thickened appendiceal diameter, thickened appendiceal wall, and distended appendiceal luminal diameter but also the present indirect sign, including The inflammatory changes of appendix around, abscess formation, adjacent bowel wall thickening, adjacent adenopathy, and extraluminal air.