多层螺旋CT与腹部超声在小儿急性阑尾炎临床诊断中的应用

Application of multi-slice spiral CT and abdominal ultrasound in clinical diagnosis of acute appendicitis in children

目的探讨多层螺旋CT与腹部超声在小儿急性阑尾炎临床诊断中的应用价值。方法选取东阳市妇幼保健院外科2016年8月至2019年8月经手术病理确诊的急性阑尾炎患儿50例为观察对象,术前均进行多层螺旋CT与腹部超声检查,记录两种检查方式所用时间,并以手术病理结果为标准,分析其诊断符合率。结果CT检查时间[(13.34±3.86)min]短于腹部超声检查时间[(23.45±4.77)min](t=11.65,P<0.05);与手术病理结果对照,多层螺旋CT对急性单纯性阑尾炎、急性蜂窝织炎性阑尾炎、急性坏疽性阑尾炎诊断符合率分别为95.24%、95.00%、100.0%;而腹部超声对急性单纯性阑尾炎、急性蜂窝织炎性阑尾炎、急性坏疽性阑尾炎诊断符合率分别为71.73%、70.00%、88.89%,二者差异均有统计学意义(χ^(2)=4.29、4.33、1.06,均P<0.05)。结论与腹部超声相比,多层螺旋CT成像更清晰,操作简便,耗时较短,诊断符合率较高,对小儿急性阑尾炎具有重要诊断价值。

Objective To investigate the application value of multi-slice spiral CT and abdominal ultrasound methods in the clinical diagnosis of acute appendicitis in children.Methods We included 50 children patients who were pathologically diagnosed with acute appendicitis by the Department of Surgery,Dongyang Maternal and Child Health Hospital from August 2016 to August 2019.Before surgery,all patients underwent multi-slice spiral CT and abdominal ultrasound examinations.We recorded the time taken to complete multi-slice spiral CT and abdominal ultrasound examinations.Taking pathological results as the diagnosis criteria,we also calculated the coincidence rate of each imaging method.Results The time we took to complete multi-slice spiral CT examination was shorter than that for abdominal ultrasound examination[(13.34±3.86)minutes vs.(23.45±4.77)minutes,t=11.65,P<0.05].The coincidence rate of multi-slice spiral CT in identifying acute simple appendicitis,acute phlegmonous appendicitis,and acute gangrenous appendicitis was 95.24%,95.00%,and 100.0%,respectively,and it was 71.73%,70.00%,88.89%,respectively for abdominal ultrasound examination.The coincidence rates in identifying acute simple appendicitis,acute phlegmonous appendicitis,and acute gangrenous appendicitis were significantly different between multi-slice spiral CT and abdominal ultrasound examinations(χ^(2)=4.29,4.33,1.06,all P<0.05).Conclusion Compared with abdominal ultrasound,multi-slice spiral CT is easier to operate,takes a shorter time in manipulation,provides more distinct images,and has a higher coincidence rate.Therefore,multi-slice spiral CT is of great diagnostic value for acute appendicitis in children.