多层螺旋CT三维重建技术对盲肠憩室炎和急性阑尾炎具有较高诊断价值

Three-dimensional reconstruction of multi-slice spiral CT has high efficacy in differential diagnosis of cecal diverticulitis and acute appendicitis

目的 探究多层螺旋CT鉴别诊断盲肠憩室炎和急性阑尾炎的价值。方法 选取2020年1月~2023年9月于长沙医学院附属第一医院、临湘市人民医院和益阳市第三人民医院收治的128例临床疑诊为急性阑尾炎的患者病历资料进行回顾性分析,患者术前均进行CT平扫和三维重建图像处理。以术后的病理结果或出院诊断为金标准,深度探究多层螺旋CT三维重建技术诊断盲肠憩室炎和急性阑尾炎的临床应用价值,分析两者的鉴别要点。结果 128例患者经手术病理或出院治疗结果证实急性阑尾炎49例,盲肠憩室炎41例,急性阑尾炎合并盲肠憩室炎21例,正常人17例。术前多层螺旋CT三维重建技术诊断盲肠憩室炎的准确度为96%;诊断急性阑尾炎的准确度为98.25%;诊断急性阑尾炎合并盲肠憩室炎的准确度为100%。CT征象:急性阑尾炎患者的阑尾增粗的比例高于盲肠憩室炎,差异有统计学意义(P<0.05);89.80%的阑尾炎患者阑尾周围有渗出而盲肠周围无渗出,82.93%的盲肠憩室炎患者盲肠周围有渗出而阑尾周围无渗出。结论 多层螺旋CT三维重建技术在急性阑尾炎和盲肠憩室炎的鉴别诊断中有较高的效能,并且能对临床治疗方式的选择提供指导性意见。

Objective To explore the value of multi-slice spiral CT in the differential diagnosis of cecal diverticulitis and acute appendicitis.Methods A total of 128 cases of suspected acute appendicitis admitted to the First Affiliated Hospital of Changsha Medical College,Linxiang People's Hospital and Yiyang Third People's Hospital from January 2020 to September 2023 were retrospectively analyzed.All patients underwent CT plain scan and 3D reconstruction image processing before surgery.With postoperative pathological results or discharge diagnosis as the gold standard,the clinical application value of three-dimensional reconstruction of multi-slice spiral CT in the diagnosis of cecal diverticulitis and acute appendicitis was deeply explored,and the key points of differentiation between the two were analyzed.Results Among the 128 patients,49 cases of acute appendicitis,41 cases of cecal diverticulitis,21 cases of acute appendicitis combined with cecal diverticulitis and 17 cases of normal people were confirmed by operation,pathology or discharge treatment.The accuracy of three-dimensional multi-slice CT in the diagnosis of cecal diverticulitis was 96%.The accuracy of diagnosis of acute appendicitis was 98.25%.The accuracy of diagnosis of acute appendicitis with cecal diverticulitis was 100%.CT signs:The proportion of appendicitis enlargement in patients with acute appendicitis was significantly higher than that with cecal diverticulitis,with statistical significance(P<0.05).89.80%of appendicitis patients had periappendicular exudation but no exudation around the cecum,82.93%of cecal diverticulitis patients had periappendicular exudation but no exudation around the appendix.Conclusion Multi-slice spiral CT 3D reconstruction technique has high efficacy in the differential diagnosis of acute appendicitis and cecal diverticulitis,and can provide guidance for the selection of clinical treatment.