多层螺旋CT鉴别诊断女性阑尾周围脓肿与右侧输卵管卵巢脓肿

Multi-slice CT in differential diagnosis of female periappendiceal abscess and right salpingotubo-ovarian abscess in women

目的观察多层螺旋CT(MSCT)鉴别诊断女性阑尾周围脓肿与右侧输卵管卵巢脓肿的价值。方法回顾性分析经手术病理证实的42例女性阑尾周围脓肿及35例右侧输卵管卵巢脓肿术前患者的CT资料,对比CT征象差异。结果阑尾周围脓肿与右侧输卵管卵巢脓肿患者之间,盆腔积液、盲肠壁增厚、盲肠或阑尾周围脂肪密度增高、盲肠周围积液、阑尾壁厚度>3 mm、阑尾直径>6 mm、阑尾区肿块、子宫阔韧带前移、肠腔外气体、阑尾粪石、卵巢周围脂肪密度增高、右侧附件区肿块、子宫骶韧带增厚、病变呈管状及是否合并左侧输卵管卵巢脓肿出现率差异均有统计学意义(P均<0.05),而乙状结肠/直肠壁增厚、阑尾不显示概率差异无统计学意义(P均>0.05)。结论女性阑尾周围脓肿与右侧输卵管卵巢脓肿各有其特征性CT表现;MSCT对鉴别诊断二者具有重要价值。

Objective To observe the value of multi-slice spiral CT(MSCT)in differential diagnosis of female periappendiceal abscess and right tubo-ovarian abscess in women.Methods MSCT data of 42 female patients with peri-appendicular abscess and 35 cases of right tubo-ovarian abscess confirmed by surgical pathology were retrospectively analyzed.The differences of preoperation CT imaging features were compared between the two groups.Results The incidence rates of free pelvic fluid,the thickness of the cecal wall,fat stranding around the appendix and/or cecum,fluid accumulation around the cecum,the thickness of the appendix wall>3 mm,the appendix diameter>6 mm,mass in the appendix area,anteriorly movement of the broad ligament of the uterus,extraluminal gas,appendix fecal stones,peri-ovarian fat stranding,the right ovarian mass,the thickness of the sacral uterine ligament,tube-shaped lesions and the comorbidity of left tubo-ovarian abscess were significantly different(all P<0.05),while of the thickness of rectosigmoid wall and appendix not being identified were not significantly different between female peri-appendicular abscess and right tubo-ovarian abscess patients(both P>0.05).Conclusion MSCT can display characteristic features of female peri-appendicular abscess and right tubo-ovarian abscess,and facilitate the differentiation of these two diseases.