MSCT在急性阑尾炎中的应用价值分析

Application Value Analysis of MSCT in Acute Appendicitis

目的探讨采用多层螺旋CT(multi-slice spiraCT,MSCT)诊断急性阑尾炎的价值。方法选择南通大学附属医院2019年2月—2021年7月收治手术病理证实的急性阑尾炎者50例,以手术病理检查结果为金标准,对MSCT平扫检查结果进行回顾性分析,评价MSCT的应用价值,并分析患者的MSCT表现,并探讨腔内气体、小气泡征对辅助诊断急性阑尾炎的价值。结果MSCT平扫检查检出急性单纯性阑尾炎22例、化脓性阑尾炎20例、坏疽性阑尾炎8例,对急性阑尾炎的检出率为100.00%。分型诊断上MSCT诊断急性阑尾炎准确率为90.00%,单纯性阑尾炎诊断准确率95.00%、化脓性阑尾炎85.71%、坏疽性阑尾炎88.89%,与手术病理结果一致性良好(Kappa=0.84)。该50例患者中腔内积气率为24.00%(12/50),腔内小气泡率为40.00%(21/50)。结论对急性阑尾炎患者采用MSCT平扫检查可有效识别阑尾炎征象,进而可实现对急性阑尾炎的分型诊断,诊断效能高,且通过MSCT平扫检查阑尾气体以及小气泡征象,有利于急性阑尾炎的辅助诊断,值得推广。

Objective To explore the value of multi-slice spira CT(MSCT)in the diagnosis of acute appendicitis.Methods A total of 50 patients with acute appendicitis confirmed by surgery and pathology were selected from February 2019 to July 2021 in Rugao Branch,Affiliated Hos⁃pital of Nantong University.Taking the results of surgical and pathological examination as the gold standard,the results of MSCT plain scan were retrospectively analyzed to evaluate the application value of MSCT.The MSCT performance of the patients was analyzed.And to explore the value of intracavitary gas and small bubble sign in auxiliary diagnosis of acute appendicitis.Results MSCT plain scan detected 22 cases of acute simple appendicitis,20 cases of suppurative appendicitis and 8 cases of gangrenous appendicitis.The detection rate of acute appendicitis was 100.00%.The accuracy rate of MSCT in diagnosing acute appendicitis on the classification diagnosis was 90.00%,95.00%in simple appendicitis,85.71%in suppurative appendicitis and 88.89%in gangrenous appendicitis,compared with the results of surgery and pathology,and the consistency was good(Kappa=0.84).In the 50 patients,the rate of air accumulation in the cavity was 24.00%(12/50),and the rate of small air bubbles in the cavity was 40.00%(21/50).Conclusion MSCT plain scan can effectively identify the signs of appendicitis in patients with acute appendicitis,and then realize the classification and diagnosis of acute appendicitis with high diagnostic efficiency.Using MSCT plain scan to check the signs of appendix gas and small bubbles is conducive to the auxiliary diagnosis of acute appendicitis,which is worthy of promotion.