不同类型急性阑尾炎CT征象比较

Comparison of CT Signs of Different Types of Acute Appendicitis

目的探讨不同类型急性阑尾炎CT征象及意义。方法选取2010年12月至2018年12月于我院进行手术治疗并病理结果确诊为穿孔急性阑尾炎患者36例与非穿孔急性阑尾炎患者49例,对其CT征象差异进行比较分析、采用Logistic回归分析差异征象与穿孔急性阑尾炎的相关性。结果穿孔与非穿孔急性阑尾炎患者阑尾增大(88.89%vs 91.84,P=0.933)、阑尾壁增厚(83.33%vs 81.61%,P=0.839)、阑尾壁强化(80.56%vs 87.76%,P=0.362)及阑尾周围脂肪内条纹(86.61%vs 89.80%,P=0.857)的出现率均高于81%;穿孔急性阑尾炎组阑尾壁强化缺损、阑尾腔外积气、蜂窝织炎以及脓肿出现率均高于非穿孔组(55.56%vs 2.04%,P<0.05;25.00%vs 4.08%,P<0.05;25.00%vs6.12%,P<0.05;75.00%vs 10.20%,P<0.05);Logistic回归分析结果显示阑尾壁强化缺损、阑尾腔外积气、蜂窝织炎以及脓肿与穿孔急性阑尾的相关性分别是为(waldχ2=4.254,P=0.040;waldχ2=3.36,P=0.067;waldχ2=4.445,P=0.036;waldχ2=4.087,P=0.044)。结论 CT征象可以较准确反应穿孔、非穿孔急性阑尾炎的特点,可以为临床判定给予可靠的影像信息。

Objective To explore the CT signs and significance of different types of acute appendicitis. Methods 36 patients with perforated acute appendicitis and 49 patients with non-perforated acute appendicitis diagnosed by pathological results who were treated with surgery in our hospital from December 2010 to December 2018 were selected. The CT signs were compared and analyzed, and Logistic regression analysis was used to analyze the correlation between signs of difference and perforated acute appendicitis. Results The incidence rates of appendix increase(88.89% vs 91.84, P=0.933), thickening of appendix wall(83.33% vs 81.61%, P=0.839), enhancement of appendix wall(80.56% vs 87.76%, P=0.362) and fat streaks around appendix(86.61% vs 89.80%, P=0.857) in patients with perforated and non-perforated acute appendicitis were higher than 81%. The incidence rates of appendix wall enhancement defect, pneumatosis in appendix cavity, cellulitis and abscess in perforated acute appendicitis group were higher than those in non-perforated group(55.56% vs 2.04%, P<0.05;25.00% vs 4.08%, P<0.05;25.00% vs 6.12%, P<0.05;75.00% vs 10.20%, P<0.05). Logistic regression analysis results showed that the correlation values between the enhancement of appendix wall, pneumatosis in appendix cavity and cellulitis and the perforated acute appendicitis were(wald χ~2=4.254, P=0.040;wald χ~2=3.367, P=0.067;wald χ~2=4.445, P=0.036;wald χ~2=4.087, P=0.044). Conclusion CT signs can accurately reflect the characteristics of perforated and non-perforated acute appendicitis, and can provide reliable image information for clinical judgment.