非增强螺旋CT扫描对急性阑尾炎的诊断价值

Non-enhanced Helical CT Scanning in the Diagnosis of Acute Appendicitis

目的 评价非增强螺旋CT扫描对急性阑尾炎的诊断价值。资料与方法 对 115例临床怀疑急性阑尾炎患者作非增强螺旋CT扫描 ,不口服或结肠内灌注对比剂 ,层厚 10mm ,Pitch 1,扫描范围从L3 椎体至耻骨联合。CT诊断急性阑尾炎的标准包括阑尾增粗横径超过 6mm ,或阑尾结石同时伴有阑尾周围的炎性改变。CT诊断结果与手术、病理或临床随访结果进行对照。结果 CT发现 5 6例真阳性 ,49例真阴性 ,7例假阴性和 3例假阳性。CT诊断急性阑尾炎的敏感性为 89%,特异性为 94%,准确性为 91%,阳性预测值为 95 %,阴性预测值为 88%。 49例无阑尾炎患者中 ,CT发现其他病变 2 2例 (45 %)。结论 非增强螺旋CT扫描 ,能快速、准确地诊断有无急性阑尾炎 ,而且还能发现除阑尾炎以外的其他各种病变。

Objective To evaluate non-enhanced helical CT scanning in diagnosing acute appendicitis.Materials and Methods Non-enhanced helical CT scanning was performed in 115 patients with clinically suspected acute appendicitis. Neither intravenous nor oral or rectal contrast materials were administered. Using a collimation of 10 mm and a pitch of 1, the scans covered from L3 level to the pubic symphysis. The CT diagnostic criteria for acute appendicitis included enlarged appendix (diameter>6 mm), or the presence of appendicolithiasis with peri-appendiceal inflammatory evidence. CT findings were correlated with pathological and follow-up results.Results CT showed 56 true-positive, 49 true-negative, 7 false-negative and 3 false-positive cases, which yielded a sensitivity of 89%, a specificity of 94%, a positive predictive value of 95%, a negative predictive value of 88%, and an accuracy of 91%. In 49 cases without appendicitis, CT detected other lesions in 22 (45%).Conclusion Non-enhanced helical CT scanning can quickly and correctly determine whether or not an acute appendicitis is present, besides, it can also detect other lesions.