CT扫描及后处理重建图像对急性阑尾炎的影像学特征、形态分析

CT scan and post-processing technology of reconstructed images in analyzing the imaging features and morphology of acute appendicitis

目的探讨多层螺旋CT(MSCT)及后处理重建图像对急性阑尾炎(AA)的影像学特征、形态诊断。方法选择本院近3年(研究时间段截取2018年9月至2021年5月)就诊的80例AA(经病理诊断)患者。所有患者均实施MSCT诊断及后处理重建图像技术[多平面重建(MPR)、曲面重建(CPR)]。对比不同CT技术对AA病理分型诊断价值、对比不同MSCT重建图像技术CT征象显示率MPR/CPR后处理诊断不同病情程度患者影像学形态及特征。结果MPR/CPR后处理MSCT技术检出率(98.75%)明显高于常规CT(76.25%)(P<0.05),两种CT技术在周围脓肿诊断中比较,差异无统计学意义(P>0.05);而在单纯性AA、坏疽性AA、PAA中检出率比较,差异有统计学意义(P<0.05)。CPR技术远段与周围组织关系、阑尾全程显示率(98.75%、97.50%)均明显优于MPR技术(46.25%、32.50%)(P<0.05)。穿孔性、NPAA患者阑尾增大、阑尾粪石、淋巴结肿大特征比较,差异无统计学意义(P>0.05);而PAA患者阑尾强化缺损、蜂窝织炎、阑尾腔积气、积液、周围脓肿征象发生率明显高于NPAA患者(P<0.05)。结论MSCT联合MPR、CPR后处理重建图像技术应用于AA诊断中效果显著,CPR技术辅助MPR技术可以充分显示远段与周围组织关系、阑尾全程,确保诊断的精确性,并根据特异性影像学特征及形态准确检出及区分病理类型,为临床治疗提供诊断依据,值得临床推广。

Objective To investigate the effects of multilayer spiral CT(MSCT)and post-processing technology of reconstructed images in the diagnosis of imaging features and morphology of acute appendicitis(AA).Methods A total of 80 patients with AA(diagnosed by pathology)who attended our hospital in the last 3 years(from September 2018 to May 2021)were selected as study subjects.All patients were diagnosed by MSCT and post-processing technology of reconstructed images[multi-planar reconstruction(MPR),curved planar reconstruction(CPR)].The diagnostic value of different CT technologies for pathological staging of AA,the CT sign display rates of different MSCT image reconstruction technologies,and the imaging morphology and features of patients with different pathogenetic conditions diagnosed by MPR/CPR post-processing technology were compared respectively.Results The detection rate of MSCT post-processed by MPR/CPR technology(98.75%)was significantly higher than that of conventional CT(76.25%)(P<0.05),and there was little difference between the two CT technologies in the diagnosis of peripheral abscess(P>0.05).However,there were great differences between the two CT technologies in the detection rate of AA,gangrenous AA,and perforative AA(PAA)(P<0.05).The display rates for the relationship between the distal segment and the peripheral tissues,and the whole appendix detected by CPR technology(98.75%,97.50%)were significantly higher than those detected by the MPR technology(46.25%,32.50%)(P<0.05).There were no statistical differences between PAA patients and non-PAA patients in signs such as enlarged appendix,appendiceal fecalith,and enlarged lymph nodes(P>0.05),but the incidence of appendiceal enhancement defect,cellulitis,pneumatization and effusion of the appendiceal cavity,and peripheral abscess was significantly higher in PAA patients than in NPAA patients(P<0.05).Conclusion MSCT combined with MPR and CPR post-processing technology of reconstructed images is effective in the diagnosis of AA.CPR technology together with MPR technology can fully display the whole appendix and the relationship between distal segment and peripheral tissues,ensure the accuracy of diagnosis,and accurately detect and distinguish pathological types according to specific imaging features and morphology,further providing diagnostic basis for clinical treatment,which is worthy of promotion in clinic.