多层螺旋CT检查在急性阑尾炎病理分型诊断中的应用价值

Application value of multi-slice spiral CT in diagnosis of pathological classification of acute appendicitis

目的:探讨多层螺旋CT(MSCT)检查在急性阑尾炎(AA)病理分型诊断中的应用价值。方法:回顾性分析2021年4月至2023年4月该院收治的126例疑似AA患者的临床资料,均进行MSCT检查,以术后病理结果为“金标准”,统计术后病理检查检出AA情况,比较不同分型AA患者MSCT征象、MSCT检查检出不同分型AA结果与术后病理结果,并分析MSCT检查检出不同分型AA结果与术后病理结果的一致性。结果:术后病理结果显示,126例疑似AA患者中,96例AA,30例非AA;不同分型AA患者粪石影、盲肠壁增厚、阑尾边界不清晰、回盲部淋巴结肿大等MSCT征象比较,差异均无统计学意义(P>0.05);不同分型AA患者阑尾周围渗出、阑尾管径>6 mm等MSCT征象比较,单纯性AA<化脓性AA<坏疽及穿孔性AA,积气影、管壁厚度>3 mm等MSCT征象比较,单纯性AA>化脓性AA>坏疽及穿孔性AA,差异均有统计学意义(P<0.05);MSCT检查结果显示,96例AA,30例非AA,其中31例单纯性AA,46例化脓性AA,19例坏疽及穿孔性AA;MSCT检查检出不同分型AA结果与术后病理结果的一致性较好(Kappa=0.978)。结论:MSCT检查在AA病理分型诊断中具有一定的应用价值。

Objective:To explore application value of multi-slice spiral CT(MSCT)in diagnosis of pathological classification of acute appendicitis(AA).Methods:The clinical data of 126 patients with suspected AA admitted to this hospital from April 2021 to April 2023 were retrospectively analyzed.All patients underwent MSCT examination.Using the postoperative pathological results as the‘gold standard’,the detection of AA was statistically analyzed.The MSCT signs of the patients with different classifications of AA and the results of different types of AA detected by MSCT and the postoperative pathological results were compared.Further,the consistency between the results of different types of AA detected by MSCT and postoperative pathological results was analyzed.Results:The postoperative pathological results showed that among the 126 patients with suspected AA,96 cases were AA and 30 cases were non-AA.There were no significant differences in the MSCT signs such as fecal stone shadow,cecal wall thickening,unclear appendix boundary and lymph node enlargement in ileocecal region among the patients with different types of AA(P>0.05).The comparison of MSCT signs such as periappendiceal exudation and appendix diameter>6 mm in the patients with different types of AA showed that simple AA<suppurative AA<gangrenous and perforated AA;the comparison of MSCT signs such as gas accumulation shadow and wall thickness>3 mm showed that simple AA>suppurative AA>gangrenous and perforated AA;and the differences were statistically significant(P<0.05).MSCT examination results showed that 96 cases were AA and 30 cases were non-AA,including 31 cases of simple AA,46 cases of suppurative AA,19 cases of gangrene and perforated AA.The consistency between the results of different types of AA detected by MSCT and the postoperative pathological results was good(Kappa=0.978).Conclusions:MSCT examination has certain application value in the diagnosis pathological classification of AA.