多层螺旋CT联合CPR在早期急性阑尾炎诊断中的应用价值

Application Value of Multi-slice Spiral CT Combined with CPR in the Diagnosis of Early Acute Appendicitis

目的研究多层螺旋CT联合曲面重建(CPR)在早期急性阑尾炎诊断中的应用价值。方法抽选本院2019年9月-2021年9月疑似早期急性阑尾炎患者60例。根据手术病理检查结果将确诊为早期急性阑尾炎患者33例设为观察组,将非急性阑尾炎患者27例设为对照组。两组均行多层螺旋CT与CPR检查,观察单一多层螺旋CT检查与多层螺旋CT联合CPR诊断早期急性阑尾炎的CT征象及病灶差异显示率,分析两种方法诊断早期急性阑尾炎的敏感度、特异度、准确性及阳、阴性预测值、Kappa值。结果重建前后CT征象差异明显,重建后CT征象周围渗出、积液、阑尾穿孔、阑尾结石显示率较重建前高(P<0.05);重建前后多层螺旋CT诊断早期急性阑尾炎的敏感度分别为66.67%、90.91%,特异度分别为59.26%、92.59%,准确性分别为63.33%、91.67%,阳性预测值分别为66.67%、93.75%,阴性预测值分别为59.26%、89.29%,Kappa值分别为0.259,0.832,重建后诊断效能较重建前高(P<0.05)。结论多层螺旋CT联合CPR有助于早期发现急性阑尾炎,可大大提高诊断效能,值得临床应用。

Objective To study the application value of multi-slice spiral CT combined with curved planar reconstruction(CPR)in the diagnosis of early acute appendicitis.Methods Sixty patients with suspected early acute appendicitis from September 2019 to September 2021 were selected.According to the results of surgical pathological examination,33 patients diagnosed with early acute appendicitis were set as the observation group,and 27 patients with non-acute appendicitis were set as the control group.The two groups underwent multi-slice spiral CT and CPR examination.The CT signs and lesion difference display rate of single multi-slice spiral CT examination and multi-slice spiral CT combined with CPR examination in the diagnosis of early acute appendicitis were observed.The sensitivity,specificity,accuracy,positive and negative predictive value and Kappa value of the two methods in the diagnosis of early acute appendicitis were analyzed.Results There were significant differences in CT signs before and after reconstruction.The display rates of exudation,effusion,appendix perforation and appendix stones around CT signs after reconstruction were higher than those before reconstruction(P<0.05).The sensitivity of multi-slice spiral CT in the diagnosis of early acute appendicitis before and after reconstruction was 66.67%and 90.91%,the specificity was 59.26%and 92.59%,the accuracy was 63.33%and 91.67%,the positive predictive value was 66.67%and 93.75%,the negative predictive value was 59.26%and 89.29%,and the Kappa value was 0.259 and 0.832,respectively.The diagnostic efficiency after reconstruction was higher than that before reconstruction(P<0.05).Conclusion Multi-slice spiral CT combined with CPR can help the early detection of acute appendicitis,which can greatly improve the diagnostic efficiency and is worthy of further clinical promotion.