64层螺旋CT 100KV低剂量平扫在急性阑尾炎诊断中的应用

Application of 64-slice spiral CT with 100kV low-dose plain scanning protocols in the diagnosis of acute appendicitis

目的探讨64层螺旋CT 100 k V低剂量平扫方法诊断急性阑尾炎的价值。方法回顾性分析上海中医药大学附属第七人民医院2015年3月至2017年8月期收治的97例临床怀疑急性阑尾炎患者的临床病理及影像资料,按照就诊时间分成A组和B组,A组55例使用常规剂量CT扫描,B组42例使用低剂量CT扫描,对比2种扫描方法的图像质量、辐射剂量和影像术前诊断准确性。结果 A组与B组患者的影像图像质量均达到诊断要求,A组图像合格率为96.3%,B组图像合格率为97.6%,两组比较差异无统计学意义(P>0.05);A组有效辐射剂量为(5.14±0.77)m Sv,B组有效辐射剂量为(3.28±0.42)m Sv,B组辐射剂量明显低于A组,差异具有显著统计学意义(P<0.01);A组术前诊断准确性为90.9%,B组术前诊断准确性为90.5%。结论 64层螺旋CT 100 k V低剂量平扫方法能满足急性阑尾炎的临床诊断要求,辐射剂量低,值得推广使用。

Objective To evaluate the value of 64-slice spiral CT with 100 k V low-dose plain scanning protocols in the diagnosis of acute appendicitis. Methods A retrospective analysis was conducted using clinical pathological data and imaging data of 97 patients with clinically suspected acute appendicitis admitted to the Seventh People＇s Hospital of Shanghai University of TCM during March 2015 and August 2017, who were divided into group A and group B according to the time of examination. Group A（n=55） received conventional dose CT scan, while group B（n=42） used low-dose CT scan. Then comparison was taken for the image quality, radiation dose and preoperative diagnostic accuracy of the two kinds of scanning methods. Results Both of the image quality in group A and group B met the diagnostic requirements. The qualified rate of group A was 96.3%, and that of group B was 97.6%, which showed no statistically significant difference between two groups（P〉0.05）. The effective radiation dose of group A was（5.14±0.77） m Sv, and that of group B was（3.28 ± 0.42） m Sv; the radiation dose of group B was significantly lower than that of group A（P〈0.010）. The accuracy of preoperative diagnosis in group A was 90.9%, and that in group B was 90.5%. Conclusion The64-slice spiral CT with 100 k V low-dose plain scanning protocols can meet the clinical diagnostic requirements of acute appendicitis. The radiation dose is significantly lower than the conventional scanning method and is worth popularizing widely.