不采用胃肠道对比剂螺旋CT平扫对不典型阑尾炎的诊断价值

目的：探讨在未使用胃肠道对比剂的情况下螺旋CT平扫对症状不典型阑尾炎的诊断价值。方法回顾性分析32例临床首诊未考虑是阑尾炎，而经手术病理证实为不典型阑尾炎病例的CT平扫及多平面重建图像表现，重点观察阑尾的位置、直径、阑尾壁的厚度、内容物及阑尾周围结构的改变。结果图像准确显示所有病例的阑尾在腹腔内的位置；其中可见阑尾增粗28例，阑尾结石9例，阑尾壁增厚8例，阑尾脓肿2例，阑尾周围炎24例，盆腔积液1例，伴有小肠梗阻6例。结论在不采用胃肠道对比剂的情况下，螺旋CT平扫联合平面重建技术可显示不典型阑尾炎的阑尾本身及其周边组织的病理改变情况，对诊断不典型阑尾炎具有重要价值。

The Value of Non-enhanced Spiral CT Scan without the Gastrointestinal Contrast Agents in Diagnosis of Atypical Appendicitis

Objective To investigate the diagnostic value of non-enhanced spiral CT scan without the gastro-intestinal contrast agents in appendicitis with atypically clinical manifestation. Methods CT scan and reconstruc-tion images of 32 cases of appendicitis which were not initially considered on ifrst clinical diagnostic conifrmed surgically and pathologically were retrospectively analyzed. The study appearance includes the location, diameter, wall thickness, content of appendix and structure around the appendix. Results CT images accurately show the location of the appendix in abdomen, and ifnd thickening appendix 28 cases, appendix stones 9 cases, thickening appendix wall 8 cases, appendix abscess 2 cases, inlfammation around appendix 24 cases, small bowel obstruction 6 cases, pelvic abscess 1 case. Conclusion Non-enhanced spiral CT scan combined with MPR technique without the gastrointestinal contrast agents can detect appendicitis appendix itself and the surrounding tissue pathological changes, so it has important diagnostic value for atypical appendicitis.