儿童不典型急性阑尾炎CT影像学特征及其诊断价值分析

CT Imaging Features and Diagnostic Value of Atypical Acute Appendicitis in Children

目的探究体层摄影(CT)诊断小儿不典型急性阑尾炎(AA)的临床价值。方法回顾性分析84例疑似AA患儿临床资料,以术中所见及病理学检测为'金标准',将患儿分为AA组(n=58)与非AA组(n=26),比较两组CT影像学特征差异,分析CT诊断效能。结果 AA组阑尾增粗、阑尾钙化影、低密度团块影、脂肪条纹征、腰大肌征、彗星尾征及箭头征出现率均明显高于非AA组(均P<0.05)。CT诊断不典型AA灵敏度为84.48%(49/58),特异度为92.31%(24/26),准确度为86.90%(73/84),Kappa值为0.715。结论不典型AA可在CT上表现出特异性影像征象,该方法诊断效能较高,可能有较大临床应用潜力。

Objective To explore the clinical value of computed tomography(CT)in the diagnosis of atypical acute appendicitis(AA)in children.Methods The clinical data of84 children patients suspected as AA were analyzed retrospectively.The intraoperative findings and pathological examination were regarded as the gold standard,and the children patients were divided into AA group(n=58)and non-AA group(n=26).The CT imaging features were compared between the two groups,and the diagnostic efficacy of CT was analyzed.Results The incidence rates of appendix thickening,appendix calcified shadow,low-density mass shadow,fat streak sign,psoas sign,comet tail sign and arrow sign in AA group were significantly higher than those in non-AA group(all P<0.05).The sensitivity,specificity,accuracy and Kappa value of CT in the diagnosis of atypical AA were 84.48%(49/58),92.31%(24/26),86.90%(73/84)and 0.715.Conclusion Atypical AA can have specific CT signs.CT has high diagnostic efficacy and great potential for clinical application.