急性阑尾炎的多层螺旋CT诊断价值

Value of Multi-slice CT in the Diagnosis of Acute Appendicitis

目的探讨急性阑尾炎的多层螺旋CT(MSCT)影像学特征及其在急性阑尾炎中诊断价值。方法将经手术病理证实的56例急性阑尾炎患者纳入本研究,所有患者术前常规行全腹部MSCT检查,总结急性阑尾炎的MSCT影像学特征。结果本组56例确诊的患者中,23例有阑尾周围的炎性浸润,33例无阑尾周围的炎性浸润,其中伴有脓肿形成6例。回盲前位、回盲后位和盲肠后位均为4例,盲肠下位21例,回肠下位23例。80.4%的患者MSCT能够清楚显示阑尾,主要表现为:阑尾肿大,阑尾直径12.1±4.6mm(6.1-21.6mm),其中9例可见阑尾腔内结石,粪石远端表现为阑尾积液并扩张。11例患者的阑尾MSCT图像不能清晰显示,仅发现阑尾周围有炎性肿块。阑尾穿孔发生率为8.9%,MSCT图像表现为粪石离开阑尾腔进入腹腔和增粗的阑尾周围可见少量积气。结论 MSCT可以清楚显示阑尾,对于急性阑尾炎具有特征性的表现,可以作为急性阑尾炎术前常规检查。

Objective To summarize the imaging characteristics and value of multi-slice CT （MSCT） in the diagnosis of acute appendicitis.Methods 56 patients with acute appendicitis confirmed by surgery and pathology were selected in this study, all patients underwent preoperative conventional whole abdominal MSCT, and MSCT imaging characteristics of acute appendicitis werer summarized.Results Of all the 56 patients, 23 cases showed periappendiceal inflammatory infiltration, and 33 cases showed no inflammatory infiltration and 6 cases showed abscess. The appendix of 4 cases located before and behind of ileocecum and behind of cecum respectively, 21 cases down of cecum and 23 cases down of ileum. MSCT can clearly show the appendix in 80.4% of the patients, and the mainly manifestation was swollen, and the average diameter was 12.1±4.6mm （6.1-21.6mm）. Appendiceal stones were found in 9 cases which showed appendix expansion and effusion. The appendix can＇t clearly show in 11 patients by MSCT. 8.9% of the patients showed appendiceal perforation. The stones were replaced from the appendix to the abdominal cavity in the MSCT images, and periappendiceal gas could be seen.Conclusion MSCT can show appendix clearly. Acute appendicitis has special characteristics on MSCT, and it can be used as a routine preoperative examination for acute appendicitis.