MSCT及MPR后处理技术在诊断阑尾疾病中应用

The application of Multi-slice CT(MSCT) with multiplanar reformation(MPR) in the diagnosis of appendiceal diseases

目的:探讨多排螺旋CT常规轴位及结合MPR技术在急性阑尾炎中的诊断价值。方法:收集盐城市第一人民医院经手术证实阑尾病变患者28例,统计CT常规轴位及结合MPR技术对阑尾疾病显示率和诊断符合率,两组方法观察及总结急性阑尾炎CT影像特征及进行比较,两组方法对病例测量数值进行统计学处理。结果:多排螺旋CT常规轴位对本组单纯C T轴位组检出16例,检出率57.1%,诊断正确14例,诊断准确率50.0%;MPR组检出率26例,检出率92.9%,正确诊断24例,诊断准确率85.7%;在急性单纯性阑尾炎时,阑尾外直径明显增粗,官腔扩大,阑尾壁增厚,周围渗出不明显;当出现化脓及坏疽、蜂窝组织炎时,阑尾本身结构模糊或消失,周围脂肪间隙密度增高,可形成渗出和炎性包块;MPR重建技术更能够多方位显示病变的阑尾形态,并能清晰显示阑尾与周围组织、器官的结构关系。结论:MSCT及结合MPR后处理技术更能可快速准确显示阑尾病变及其并发症,达到对阑尾疾病明确诊断及鉴别诊断,对于一些急腹症患者,尤其是怀疑急性阑尾炎患者,应首选MSCT及MPR后处理技术进行有效观察。

Objective To investigate the diagnostic value of multi-slice spiral CT combined with MPR in acute appendicitis.Methods 28 patients with surgically confirmed appendicitis in the Yancheng First People's Hospital were collected,the display rate and diagnostic coincidence rate of appendicitis disease were calculated by CT conventional axial position and combined with MPR technology,the CT image characteristics of acute appendicitis were observed and summarized by the two groups,and the measured values were statistically processed by the two groups.Results In this group,16 cases were detected by conventional multi-slice spiral CT in the simple CT axial position group,the detection rate was 57.1%,the diagnosis was correct in 14 cases,and the diagnosis accuracy was 50.0%.In the MPR group,the detection rate was 26 cases,the detection rate was 92.9%,and the correct diagnosis was 24 cases,the diagnostic accuracy was 85.7%.In acute simple appendicitis,the external diameter of the appendix was obviously thickened,the cavity was enlarged,the appendix wall was thickened,and the surrounding exudation was not obvious.When pyogenesis and gangrene,cellulitis,appendiceal itself structure fuzzy or disappear,the surrounding fat gap density increased,can form ooze and inflammatory mass;MPR reconstruction technology can better display the shape of the diseased appendix in multiple directions,and can clearly show the structural relationship between the appendix and surrounding tissues and organs.Conclusion MSCT and MPR post-processing technology can more quickly and accurately display appendicitis and its complications,so as to make a definite diagnosis and differential diagnosis of appendicitis.For patients with acute abdomen,especially those suspected of acute appendicitis,MSCT and MPR postprocessing technology should be the first choice for effective observation.