多层螺旋CT对急性阑尾炎及其并发症的诊断价值

The Application of Multi-slice Spiral CT in the Diagnosis of Acute Appendicitis and Complications

目的:探讨多层螺旋CT(MSCT)对急性阑尾炎及其并发症的诊断价值。方法:收集75例术后病理证实为急性阑尾炎患者的术前MSCT平扫联合重建[包括多平面重建(MPR)、曲面重建(CPR)、最大密度投影(MIP)、容积再现技术(VRT)]联合CT增强的病例资料,总结急性阑尾炎及并发症的CT表现,并与急性阑尾炎病理分型进行比较,记录MSCT平扫联合增强联合重建对急性阑尾炎的诊断符合率。结果:本组64排螺旋CT平扫联合重建(MPR、CPR、MIP、VR)联合增强技术对急性阑尾炎诊断符合率为80%,75例患者中,经MSCT联合重建联合CT增强诊断急性化脓性阑尾炎43例(57.3%)、坏疽性或穿孔型阑尾炎9例(12.0%)、急性单纯性阑尾炎8例(10.67%)、阑尾周围脓肿1例(1.3%);漏诊7例、误诊为盲肠肿瘤3例、误诊为脂膜炎3例、误诊为盆腔炎1例,诊断符合率81.3%、漏诊率9.3%、误诊率9.3%。结论:MSCT平扫联合重建联合增强技术对阑尾炎及其并发症具有一定的诊断价值。

Objective： To assess the applied value of multi-slice spiral CT（ MSCT） in the diagnosis of acute appendicitis and its complications. Methods： Seventy-five cases with acute appendicitis were collected and examined by MSCT flat scan,reconstruction [ including multiplanar reconstruction（ MPR）,curved planar reconstruction（ CPR）,maximum intensity projection（ MIP）,and volume reproduction technology（ VRT） ] and enhanced CT. The CT performance of acute appendicitis and its complications was summarized and compared with pathological types. The diagnostic accuracy rate of MSCT flat sweep,enhanced CT and above-mentioned reproductions in the diagnosis of acute appendicitis was recorded. Results： In the diagnosis of 64 cases through MSCT,reproductions（ MPR,CPR,MIP,VR） and enhancement technology for acute appendicitis,the diagnostic accuracy was 80%.Conclusion： MSCT scan together with reproductions and enhancement technique has high diagnostic value for appendicitis and its complications.