MSCT诊断不同病理类型急性阑尾炎患者的价值

The Value of MSCT in Diagnosing Patients with Acute Appendicitis of Different Pathological Types

目的:研究多层螺旋CT(MSCT)诊断不同病理类型急性阑尾炎患者的价值。方法:回顾性分析青岛市黄岛区人民医院2017年1月-2021年1月收治的60例急性阑尾炎患者的临床资料。所有患者均进行超声检查及MSCT检查。比较超声检查及MSCT诊断符合率。分析60例患者超声检查及MSCT清晰度分布情况,不同病理类型急性阑尾炎患者MSCT征象。结果:经术后病理检查判断,60例急性阑尾炎患者中,急性单纯性阑尾炎33例(55.00%),急性化脓性阑尾炎20例(33.33%),急性坏疽性阑尾炎7例(11.67%)。超声检查诊断出急性单纯性阑尾炎27例,急性化脓性阑尾炎13例,急性坏疽性阑尾炎7例,诊断符合率为76.67%(46/60);MSCT检查诊断出急性单纯性阑尾炎33例,急性化脓性阑尾炎15例,急性坏疽性阑尾炎7例,诊断符合率为91.67%(55/60)。MSCT检查急性阑尾炎病理类型诊断符合率显著高于超声检查(χ^(2)=5.065,P=0.024)。MSCT检查急性阑尾炎的清晰度显著优于超声检查(P<0.05)。急性化脓性阑尾炎、坏疽性阑尾炎患者阑尾直径显著长于急性单纯性阑尾炎患者;急性坏疽性阑尾炎患者的平均阑尾管壁厚度显著高于急性单纯性阑尾炎、化脓性阑尾炎患者;急性化脓性阑尾炎、坏疽性阑尾炎患者的周围渗出发生率显著高于急性单纯性阑尾炎患者(P<0.05)。结论:应用MSCT诊断急性阑尾炎病理类型诊断符合率较高,且不同病理类型急性阑尾炎在MSCT下征象具有特异性,临床诊断时可以此作为鉴别指导。

Objective:To study the the value of multi-slice spiral CT(MSCT)in diagnosing patients with acute appendicitis of different pathological types.Method:The clinical data of 60 patients with acute appendicitis treated in Qingdao Huangdao District People’s Hospital from January 2017 to January 2021 were analyzed retrospectively.All patients were examined by ultrasound and MSCT.The diagnostic coincidence rate of ultrasound examination and MSCT was compared.The ultrasound examination and MSCT definition distribution condition of 60 patients were analyzed,and the MSCT signs of patients with acute appendicitis of different pathological types were analyzed.Result:According to the postoperative pathological examination,among the 60 patients with acute appendicitis,there were 33 cases of acute simple appendicitis(55.00%),20 cases of acute suppurative appendicitis(33.33%),and 7 cases of acute gangrenous appendicitis(11.67%).Ultrasound examination diagnosed 27 cases of acute simple appendicitis,13 cases of acute suppurative appendicitis and 7 cases of acute gangrenous appendicitis,with a diagnostic coincidence rate of 76.67%(46/60);MSCT examination diagnosed 33 cases of acute simple appendicitis,15 cases of acute suppurative appendicitis and 7 cases of acute gangrenous appendicitis,with a diagnostic coincidence rate of 91.67%(55/60).The diagnostic coincidence rate of pathological types in acute appendicitis examined by MSCT was significantly higher than that by ultrasound(χ^(2)=5.065,P=0.024).The definition of acute appendicitis examined by MSCT was significantly better than that examined by ultrasound(P<0.05).The appendix diameter in patients with acute suppurative appendicitis and gangrenous appendicitis was significantly longer than that in patients with acute simple appendicitis;the average appendix wall thickness of patients with acute gangrenous appendicitis was significantly higher than patients with acute simple appendicitis and suppurative appendicitis;the incidence of peripheral exudation in patients with acute suppurative appendicitis and gangrenous appendicitis was significantly higher than patients with acute simple appendicitis(P<0.05).Conclusion:The application of MSCT in the diagnosis of acute appendicitis pathological types has a high diagnostic coincidence rate,and the signs of different pathological types of acute appendicitis have specificity under MSCT,which can be used as identification guidance in clinical diagnosis.