多层螺旋CT平扫对成人正常阑尾的显示价值

目的 评价16层螺旋CT平扫对成人正常阑尾的显示率及影像表现。方法 随机选择243例行Siemens Sensation16CT腰椎检查的既往无急慢性阑尾炎史及阑尾切除史的患者，薄层图像连续观察并辅以冠状位、矢状位和斜位重组。记录阑尾的显示率、壁厚、直径、有无结石、阑尾基底位置及尖端位置。结果 243例中，显示正常阑尾217例（89.3%）。阑尾平均直径（6.5±1.5）mm；阑尾平均壁厚（2.8±0.96）mm。阑尾结石24例（9.8％）。216例可以同时分辨回盲瓣及阑尾结构，阑尾基底位于回盲瓣尾侧201例（92.6％），头侧5例（2.3％），同样高度10例（4.6％）；位于回盲瓣后方195例（89.9％），前方9例（4.1％），外侧12例（5.5％）。217例显示阑尾尖端位置，其中髂窝位69例（31.8％），盆腔位49例（22.6％），结盲肠内侧位57例（26.3％），结盲肠后35例（16.1％），盲肠外5例（2.3％），盲肠前2例（0.9%）。结论 多层螺旋CT平扫后薄层图像连续观察，辅以多平面图像重组，89.3％的成人可以识别并显示阑尾全程结构。

The value of Plain Multi-slice spiral CT for Normal Appendix in adulthood

【Abstract】Objective To evaluate imaging findings of the normal appendix in adulthood on plain 16-slice CT. Methods 243 patients without history of acute or chronic appendicitis and history of appendectomy were randomly selected, and underwent Siemens Sensation 16-slice CT scan. Observed by continuous thin-layer images and coronal, sagittal and oblique image reconstruction. To record the frequency of visualization, maximum full thickness, maximum thickness of the two walls, appendolith, the location of the base and the tip of the appendix. Results The appendix was definitely visualized in 217 of 243 patients, the display rate of the normal appendix was 89.3%. The mean outer diameter of the appendix was 6.5±1.5mm(range:2.8-12.6mm). The mean wall thickness of the appendix was 2.8±0.96mm (range:0.2-5.5mm). Appendicolith in 24 cases (9.8%).Both the ileocecal valve and appendix were visualized in 216 cases, The relationship of the the base of the appendix to the ileocecal valve was caudal in 201 (92.6%) and cephalic in 5(2.3%) and the same height in 10(4.6%). The appendiceal base was posterior to the ileocecal valve in 195(89.9%), anterior in 9(4.1%), lateral in 12(5.5%). The location of the appendiceal tip was iliac fossa in 69(31.8%), pelvic in 49(22.6%), medial of cecum in 57(26.3%), retrocecal in 35(16.1%), lateral of cecum in 5(2.3%), front of cecum in 2(0.9%). Conclusion 89.3% of the normal appendix in adulthood can be identified and displayed completely on plain MSCT scan by continuous thin-layer images and multiplanar reconstruction.