成人急性阑尾炎病变阑尾解剖位置的多层螺旋CT评价

Evaluation of Multi-slice Spiral CT in the Anatomy of Appendicitis in Adult Patients with Acuteappendicitis

目的探讨成人急性阑尾炎病变阑尾解剖位置的多层螺旋CT(MSCT)诊断价值。方法收集我院经手术及病理学检查证实的118例成人急性阑尾炎患者临床及影像资料,回顾性分析MSCT所示病变阑尾解剖位置,并与手术所见对照。结果 MSCT图像显示病变阑尾位置:盆位35例(29.7%);回肠后位25例(21.2%);盲肠下位23例(19.5%);盲肠后位17例(14.4%);回肠前位10例(8.5%);盲肠外位5例(4.2%);高位2例(1.7%);盲肠内位,1例(0.8%)。与手术所见对照差异无统计学意义(P>0.05)。结论 MSCT能较好地显示成人急性阑尾炎病变阑尾的不同解剖位置,可为临床诊断、鉴别诊断、手术方案的制定和手术入路的选择提供可靠的依据。

Objective To investigate the value of multi-slice spiral CT（ MSCT） in the diagnosis of appendicitis in adults.Methods The clinical and imaging data of 118 adult patients with acute appendicitis confirmed by surgery and pathology were collected. The anatomic location of the appendix was analyzed retrospectively and compared with that of the operative findings in MSCT. Results The diseased appendix position was showed by MSCT image： 35 cases of pelvic position,accounting for 29. 7%;25 cases after the ileum,accounting for 21. 2%; Lower appendix 23 cases,accounting for 19. 5%; 17 cases of the posterior position of the appendix,accounting for 14. 4%; 10 cases of the anterior ileum,accounting for 8. 5%; the outer position of the Appendix 5cases,accounting for 4. 2%; high 2 cases,accounting for 1. 7%; the inside of the appendix,1 cases,accounting for 0. 8%. There was no significant difference（ P〈0. 05） in the control and operation. Conclusion MSCT can better display the different anatomical position of appendicitis in adult patients with acute appendicitis. It can provide a reliable basis for clinical diagnosis,differential diagnosis,surgical planning and selection of operative approach.