急性阑尾炎穿孔的CT诊断及图像特征分析

Analysis of CT diagnosis and its image features of perforation of acute appendicitis

目的分析急性阑尾炎穿孔的CT诊断价值及图像特征。方法选择我院2012年1月至2014年2月拟诊为急性阑尾炎穿孔的112例患者作为研究对象,所有患者均有完整的超声、CT影像学资料以及病理资料,比较超声、CT两种检查方法的准确度、灵敏度及特异度并分析图像特征。结果 CT检查的的诊断灵敏度、特异度以及准确率分别为98.1%、87.5%、97.3%,超声的诊断灵敏度、特异度以及准确率分别为90.4%、62.5%、88.4%,CT检查的诊断灵敏度及准确率均显著高于超声,组间差异均有统计学意义(P<0.05);CT图像主要特征表现在异常的阑尾周围蜂窝织炎,阑尾周围脓肿,阑尾腔外积气、结石,增强扫描局部阑尾壁强化缺损。结论急性阑尾炎穿孔的CT诊断在准确度及特异度方面体现了显著的临床优势,具有易于辨别的图像特征,可以作为重要的临床参考依据。

Objective To analyze the diagnostic value of CT imaging and its image features in perforation of acute appendicitis. Methods 112 patients diagnozed as perforation of acute appendicitis from January 2012 to February 2014 in our hospital were selected as the research object. All patients had complete data of ultrasound, CT imaging and pathology. The accuracy, sensitivity and specificity of ultrasound and CT imaging were compared, and the image features were analyzed. Results The diagnostic sensitivity, spe- cificity and accuracy of CT were 98.1% , 87.5% , 97.3% , respectively, significantly higher than those of ultrasound （90.4% , 62.5% , and 88.4% , respectively） （P 〈0.05）. The CT images were mainly characterized by abnormalities in the appendix surrounding cellulitis, appendix abscess, extraluminal air, stones, and enhanced scan of local appendiceal wall showing no enhancement. Conclusions CT diagno- sis of perforation of acute appendicitis shows significant clinical advantages of accuracy and specificity. It has easily identifiable image features, and can be used as an important clinical reference for diagnosis and treatment of perforation of acute appendicitis.