超声检查联合CT检查在急性阑尾炎诊断中的价值

Value of ultrasonography combined with CT in the diagnosis of acute appendicitis

目的研究超声检查联合CT检查在急性阑尾炎诊断中的价值。方法选取2020年9月至2021年10月共青城市人民医院收治的60例疑似阑尾炎患者作为研究对象,均完成相应的超声检查、CT检查及联合检查,对不同检测方式诊断急性阑尾炎的一致性、受试者工作特征(ROC)曲线、影像学征象表现进行比较分析。结果CT检查、超声检查及联合检查的检测准确率分别为88.33%、83.33%、95.00%,联合检测的准确率更高;CT检查、超声检查及联合检查与病理诊断急性阑尾炎的Kappa检验一致性为0.691、0.556、0.864,联合诊断的Kappa检验一致性更高。采取ROC曲线对不同检测方式的检测价值进行分析,结果显示CT检查、超声检查、联合检查诊断急性阑尾炎的ROC曲线分别为0.891、0.781、0.913,标准误分别为0.028、0.064、0.031(P<0.05)。急性阑尾炎主要征象表现中,联合检测所显示的阑尾周围炎、腹膜炎征象发生率高于CT检查及超声检查,差异有统计学意义(P<0.017)。患者住院时间5~20 d,平均(9.32±1.11)d;患者住院费用(2~15)千元,平均(5.11±0.71)千元。结论超声检查联合CT诊断能提高诊断准确性。

Objective To study the value of ultrasound combined with CT in the diagnosis of acute appendicitis.Methods A total of 60 patients with suspected appendicitis who received medical treatment in People′s Hospital of Gongqingcheng City from September 2020 to October 2021 were selected as the research objects,and all of them completed the corresponding ultrasonic examination,CT examination and combined examination.The consistency,receiver operating characteristic(ROC)curve and imaging manifestations of different detection methods in the diagnosis of acute appendicitis were compared and analyzed.Results The detection accuracy of CT examination,ultrasound examination and combined examination were 88.33%,83.33%and 95.00%respectively,and the accuracy of combined detection was higher.The Kappa test consistency of CT examination,ultrasound examination and combined examination with pathological diagnosis of acute appendicitis was 0.691,0.556,0.864,and the Kappa test consistency of combined diagnosis was higher.The ROC curve was used to analyze the detection value of different detection methods.The results showed that the ROC curve of CT examination,ultrasound examination and combined examination in the diagnosis of acute appendicitis were 0.891,0.781,0.913,and the standard error was 0.028,0.064,0.031 respectively(P<0.05).Among the main signs of acute appendicitis,the incidence of periappendicitis and peritonitis showed by combined detection were higher than those by CT and ultrasound examination,and the differences were statistically significant(P<0.017).The average hospital stay was ranged from 5 to 20 d,with an average of(9.32±1.11)d.The hospitalization cost of patients ranged from 2 thousand to 15 thousand yuan,with an average of(5.11±0.71)thousand yuan.Conclusion Ultrasonic examination combined with CT diagnosis can improve the diagnostic accuracy.