多层螺旋CT与超声对急性阑尾炎患者的临床诊断价值

Comparative analysis of the clinical diagnostic value of multi-slice spiral CT and ultrasound in patients with acute appendicitis

目的比较分析多层螺旋CT与超声对急性阑尾炎患者的临床诊断价值。方法选取我院收治的63例急性阑尾炎患者作为研究对象,分别进行多层螺旋CT与超声检查,将检查结果与手术病理结果相比较,分析两者的临床诊断价值。结果与手术病理比较,多层螺旋CT对阑尾结构完整可辨、阑尾结构难辨、阑尾结构不清、团块等各型的诊断符合率分别为95.24%、80.00%、100.00%、100.00%。超声的诊断符合率分别为83.33%、66.67%、75.00%、100.00%。多层螺旋CT的总诊断符合率明显高于超声,多层螺旋CT与超声对急性单纯性阑尾炎的诊断符合率分别为100.00%、59.46%。急性化脓性阑尾炎的诊断符合率分别为75.00%、50.00%,急性坏疽性阑尾炎的诊断符合率均为100.00%。多层螺旋CT的诊断符合率明显高于超声,尤其是对急性单纯性阑尾炎的诊断符合率明显高于超声,差异具有统计学意义(P<0.05)。结论多层螺旋CT应用于急性阑尾炎的诊断及分型,与临床病理诊断符合率高于超声。典型的CT征象为阑尾直径>6mm、阑尾及周围肠壁增厚、存在积液等,为急性阑尾炎的诊断提供参考。

Objective To comparatively analyse of the clinical diagnostic value of multi-slice spiral CT and ultrasound in patients with acute appendicitis. Methods 63 cases of acute appendicitis in our hospital were selected as the research objects. They were examined by multi-slice spiral CT and ultrasonography. The results were compared with surgical pathology results, and their clinical diagnostic value was analyzed. Results Compared with surgery and pathology, the diagnostic accordance rate of multi-slice spiral CT for the complete appendix structure, the appendix structure difficult to distinguish, the appendix structure unclear and the lump type were 95.24%, 80%, 100% and 100%, respectively. The diagnostic coincidence rates of ultrasound were 83.33%, 66.67%, 75% and 100% respectively. The overall diagnostic coincidence rate of multi-slice spiral CT was significantly higher than that of ultrasound. The diagnostic accordance rate of multi-slice spiral CT and ultrasound for acute simple appendicitis was 100% and 59.46% respectively. The diagnostic coincidence rate of acute suppurative appendicitis was 75% and 50% respectively, and the diagnostic coincidence rate of acute gangrenous appendicitis was 100%. The diagnostic coincidence rate of multi-slice spiral CT was significantly higher than that of ultrasound, especially for acute simple appendicitis. The coincidence rate of diagnosis was significantly higher than that of ultrasound, and the difference was statistically significant （ P 〈0.05）. Conclusion Multislice spiral CT is used in the diagnosis and classification of acute appendicitis, and the coincidence rate with the clinicopathological diagnosis is higher than that of ultrasound. The typical CT signs are the 〉6mm of the appendix diameter, the thickening of the appendix and the surrounding intestinal wall, and the existence of the effusion, which can provide a reference for the diagnosis of acute appendicitis.