多层螺旋CT三维重建对急性阑尾炎的诊断价值

目的探讨多层螺旋CT三维重建对急性阑尾炎的诊断价值。方法搜集58例临床拟诊为急性阑尾炎的病例,行多层螺旋CT检查,并经工作站进行多平面重建及曲面重建,分析其CT表现并将诊断结果与手术病理结果对照。结果58例病人中,诊断急性阑尾炎53例,升结肠癌2例,右侧腹股沟疝2例,假阴性1例。急性阑尾炎多层螺旋CT的主要征象及出现频率如下：阑尾肿大增粗（管腔直径〉6mm）占96．2％,阑尾结石占17．0％,回盲部壁增厚占30．1％,阑尾周围炎占60．4％,阑尾周围脓肿占15．1％,阑尾穿孔占9．4％。结论急性阑尾炎有典型的CT征象,多层螺旋CT三维重建图像后处理技术能多方位显示阑尾本身及其周围组织情况,在急性阑尾炎的诊断中具有较高的临床应用价值。     

多层螺旋CT平扫在急性阑尾炎诊断中的价值

目的：探讨多层螺旋CT诊断急性阑尾炎的价值。方法：回顾性分析经手术证实45例急性阑尾炎患者腹部多层螺旋CT影像资料。结果：多层螺旋CT诊断急性阑尾炎43例,诊断准确率95.6％。多层螺旋CT显示阑尾增粗38例,阑尾壁增厚38例,阑尾周围炎36例,阑尾腔内结石26例,阑尾腔内积液17例、积气5例,阑尾周围脓肿7例。结论：多层螺旋CT平扫可清晰显示急性阑尾炎病变影像,有助于疾病诊断。     

腹部多层螺旋CT对急性阑尾炎的诊断价值

目的:研究AA(急性阑尾炎)采用多层螺旋CT诊断的临床意义。材料与方法:将我院自2012年3月至2015年3月收治的45例AA患者作为AA组,选择同期45例CNA(阑尾区域复杂病变)者、45例NCNA(阑尾区域非复杂病变)者作为对照组,三组均予腹部多层螺旋CT检查,以CPR、MPR法实施后处理,对比三组阑尾直径、壁厚度、腔内液体最大直径,并观察三组阑尾壁异常强化、壁增厚、粪石的发生情况。结果:AA组阑尾直径、阑尾腔内液体最大直径与CNA组、NCNA组对比,有统计学意义(P0.05),阑尾壁厚度与CNA组、NCNA组对比,无统计学意义(P0.05)。AA组阑尾壁异常强化与CNA组、NCNA组对比,有统计学意义(P0.05),但阑尾壁增厚、粪石与CNA组、NCNA组对比,均无统计学意义(P0.05)。结论:AA患者采用多层螺旋CT检诊,不仅定位明确,而且对阑尾及其周围病变可以清晰、直观的显示,具有极高的诊断符合率,应予推广。     

小儿急性阑尾炎CT联合B超检查的临床意义

目的探讨CT和B超检查诊断小儿急性阑尾炎的临床意义。方法回顾性分析53例小儿急性阑尾炎的临床、CT和B超特征。结果CT与B超共同诊断为单纯性阑尾炎17例、化脓性阑尾炎13例、坏疽性阑尾炎10例、阑尾周围脓肿13例；急性阑尾炎的CT直接征象为阑尾肿大增粗（直径〉6mm）、壁增厚和阑尾石，间接征象有阑尾．盲肠周围脂肪内条索影等；B超征象为阑尾肿胀增粗（直径〉6mm），壁增厚≥2mm，浆膜层毛糙，回声增强，黏膜毛糙，回声中断或阑尾内积液、积脓或粪石。结论CT和B超两者结合对急性阑尾炎的诊断特别是对临床表现不典型的阑尾炎具有很高准确率。     

多层螺旋CT检查在阑尾炎术前中的诊断价值

[目的]探讨多层螺旋CT（MSCT）检查在阑尾炎术前中的诊断价值.[方法]选择经手术病理证实的阑尾炎患者99例,术前均行常规盆腔CT扫描和冠状、矢状、平行髂骨和垂直髂骨四个方位的多平面重建（MPR）,分析其影像学特征.[结果]阑尾显示率90.9%（90/99）;阑尾平均直径14.0（6.2～26.6）mm,显示阑尾的最佳截面：冠状位59例,矢状位19例,垂直髂骨7例,平行髂骨4例,轴位1例;阑尾位置：回肠后位30例,盲肠后位6例,回肠前位11例,盲肠前位4例,盲肠下位39例;阑尾梗阻部位：根部86例,中间4例,可见明确粪石43例,未见明确粪石47例;阑尾周围炎性浸润56例,无炎性浸润30例,脓肿形成13例,合并穿孔1例.[结论]MSCT检查在阑尾炎术前中的诊断价值高,值得临床推广应用.     

多层螺旋CT平扫及重建技术在急性阑尾炎诊断中的应用

目的:分析多层螺旋CT平扫及重建技术在急性阑尾炎诊断中的应用效果及价值。方法:本次实验选取我院66例病例,均为经手术病理证实为急性阑尾炎患者,研究时间2019年5月—2020年10月。患者均采用超声及多层螺旋C T平扫及多平面重建及曲面重建等重建技术诊断,对比分析诊断效果,分析多层螺旋CT平扫及重建技术在急性阑尾炎中的应用价值。结果:本次研究中,采用超声诊断急性阑尾炎的可信度分布在5分的有84.8%,与采用多层螺旋C T诊断的5分可信度比例相比,有统计学差异(P<0.05)。其他可信度分值分布对比无显著差异(P>0.05)。手术病理证实66例患者均为急性阑尾炎发作。多层螺旋CT诊断与超声诊断相比之下,多层螺旋CT的诊断准确性更高(P<0.05)。多层螺旋CT采取平扫及重建技术观察,将阑尾横径大于6 mm,阑尾管壁横径大于2 mm的检出情况判定为阑尾异常。出现阑尾异常增粗、增大,见阑尾腔积气积液,以及呈现“靶征”,刺猬直接征象,而出现阑尾周围炎性渗出、脂肪间隙模糊,阑尾粪石影,盲肠壁局限性增厚的“箭头征”;阑尾周围脓肿、包块及淋巴结形成,残留的阑尾影以及阑尾周围蜂窝织炎、阑尾脓肿及伴随低位小肠梗阻为其间接征象。结论:急性阑尾炎采用多层螺旋CT平扫及重建技术进行诊断,可提升图像的清晰度,通过多平面及多角度的探查,提升对急性阑尾炎的诊断价值,并通过不同影像特诊的分析,提高各种疾病分型的检出率,为临床治疗提供更加准确的判断依据。     

64层螺旋CT曲面重建及多平面重建技术对急性阑尾炎的诊断价值

目的：探讨64层螺旋CT多平面重建及曲面重建技术对急性阑尾炎的诊断价值。方法：回顾性分析60例行64层螺旋CT检查并经病理证实的急性阑尾炎病例。将常规扫描读片结合多平面重建、曲面重建的读片结果与常规横断位阅片结果进行对比分析,比较两者在诊断急性阑尾炎中的差异。结果：64层螺旋CT多平面重建及曲面重建联合应用阑尾显示率达到100％（60／60）,阑尾外径增大、阑尾壁增厚的显示率也明显提高。结论：联合应用64层螺旋CT多平面重建及曲面重建可以更准确地识别阑尾,从而提高阑尾炎诊断的准确率。     

主动脉壁内血肿的64-MSCTA诊断及影像特征

目的：探讨主动脉壁内血肿的64层螺旋CT血管成像（MSCTA）的诊断价值及影像特征。方法：临床怀疑主动脉夹层行多排螺旋CT扫描确诊为主动脉壁内血肿9例,采用多平面重建（MPR）,曲面重建（CPR）,最大密度投影（MIP）等方法显示壁内血肿及血管壁溃疡并按Stanford分型。结果：9例主动脉壁内血肿,3例为A型,6例为B型。CT主要表现为：①主动脉壁呈环壁增厚或偏侧性新月形增厚,增厚血肿壁≥5mm（9例）;②主动脉内壁溃疡形成（４例）;③内膜瓣钙化、内移征（3例）;④并发胸腔积液、心包积液（７例）。结论：CTA薄层轴位结合MPR、CPR及MIP均可清楚显示血肿的部位、累及范围、血肿程度以及并发症,64-MSCTA检查可对主动脉壁内血肿进行明确诊断及鉴别诊断。     

多排螺旋CT三维重建在复杂性肛瘘定位诊断中价值

目的探讨多排螺旋CT三维重建在复杂性肛瘘定位诊断中的临床应用价值。方法复杂性肛瘘患者18例,瘘管造影后行多排螺旋CT扫描,将原始数据进行曲面重建（curved planar reconstruction,CPR）和容积重建（volume rendering,VR）,并与术后结果进行对照,分析多排螺旋CT三维重建技术用于肛瘘定位、分型的准确性。结果多排螺旋CT准确诊断低位复杂性肛瘘12例,高位复杂性肛瘘6例,其中2例高位复杂性肛瘘误诊为低位复杂性肛瘘,诊断准确率为88．9％;准确定位肛瘘内口29个,漏诊3个,定位准确率为90．6％;发现肛瘘支管38条,漏检3条,准确率为92．7％。结论瘘管造影后行多排螺旋CT三维重建可充分显示复杂性肛瘘的立体形态,为手术方案制定提供影像学依据。     

64排螺旋CT血管造影诊断主动脉夹层

目的：探讨64排螺旋CT血管成像诊断主动脉夹层的价值。方法：主动脉夹层患者23例,均行64排螺旋CT血管成像检查,采用容积重建、多平面重建及曲面重建等方法进行三维重建。结果：DeBakeyI型8例（34．8％）,Ⅱ型3例（13．0％）,Ⅱ型12例（52．2％）。主动脉重要分支受累5例（21．7％）,均在三维重建中有特征表现。结论：64排螺旋CT血管成像是诊断主动脉夹层准确、快捷、有效地检查方法。     

多层螺旋CT及后处理技术在急性阑尾炎诊断中的价值

目的:探讨多层螺旋CT(MSCT)及图像后处理技术对急性阑尾炎的诊断价值。方法:67例临床拟诊为急性阑尾炎的病例行MSCT检查,并经工作站进行多层面重建(MPR)及曲面重建(CPR)图像后处理,分析其CT表现并与手术病理结果对照。结果:急性阑尾炎MSCT的主要征象有阑尾管腔直径增粗(直径>6mm)、管壁增厚38例,阑尾周围炎31例,阑尾结石19例,回盲部管壁肥厚15例,阑尾脓肿12例,阑尾炎性包块7例。MSCT对急性阑尾炎诊断的敏感性、特异性、准确度、阳性预测值、阴性预测值分别为95%、82%、93%、96%、75%。结论:急性阑尾炎有典型的CT表现。MSCT及图像后处理技术能多方位显示阑尾本身及其周围组织改变及合并症,可显著提高急性阑尾炎的术前诊断准确率。     

Sonographic examination of the appendix in acute infectious enteritis and acute appendicitis

PURPOSE: To use transabdominal sonography to determine the frequency of visualization of the adult normal appendix in patients with suspected acute infectious enteritis (AIE) compared with patients with acute appendicitis (AA) and a control group. METHODS: A total of 296 patients divided into 3 different groups underwent sonographic examination, including 120 randomly selected asymptomatic patients, 91 consecutive patients with AIE, and 85 consecutive patients with AA. In the 3 groups, visualization rate, outer appendiceal diameter, presence or absence of inflamed periappendiceal fat, and location of the appendix were recorded. RESULTS: The visualization rates of the appendix were 49.2%, 70.3%, and 96.5% for the control, AIE, and AA groups, respectively (P < 0.05). The mean +/- SD outer appendiceal diameters for the 3 groups were 4.5 +/- 1.2 mm, 4.5 +/- 1.4 mm, and 7.9 +/- 2.0 mm, respectively. The difference between outer appendiceal diameter in the control and AIE groups was not statistically significant. Periappendiceal inflamed fat was detected in all AA cases, but in none of the AIE cases. CONCLUSION: The appendix was visualized more often in patients with AIE than in the control group, although the outer appendiceal diameter of the AIE group was not significantly different from that of the normal appendix seen in the control group.     

CT对阑尾粘液囊腺瘤和类癌的诊断价值

目的研究对阑尾粘液囊腺瘤和类癌的CT鉴别诊断。方法选择50例阑尾粘液囊腺瘤患者和20例类癌患者,其中男性32例,女性38例,年龄57.15±5.28岁。通过CT检测成像系统检测阑尾粘液囊腺瘤和类癌表现症状,对患者阑尾图像阑尾壁厚度、直径、钙化情况、周围侵犯情况、阑尾壁增厚、壁异常强化、粪石发生率以及检出率和准确率进行对比分析,同时对CT检测异质性分析和相关影响因素进行总结。结果阑尾粘液囊腺瘤和类癌患者CT检查图像中阑尾壁厚度、直径、钙化情况、周围侵犯情况、阑尾壁增厚、壁异常强化、粪石发生率以及检出率和准确率的差异存在统计学意义（P<0.01）,且类癌组患者较囊腺瘤组患者症状更显著。异质性检测结果显示,类癌组的敏感度、特异度、阳性比、阴性比和诊断比值比最大,且病程、年龄和发病范围与CT评估阑尾粘液囊腺瘤和类癌诊断价值的相关性最高,而囊腺瘤体积与CT评估阑尾粘液囊腺瘤和类癌诊断价值的相关性较低。结论CT鉴别诊断阑尾粘液囊腺瘤和类癌的价值较高,值得临床应用广泛推广。      

Sonographic appearance of the normal appendix in adults.

OBJECTIVE: To evaluate the sonographic visualization of the normal adult appendix, a large series of sonographic images from consecutive asymptomatic patients was analyzed. METHODS: A total of 788 consecutive adult patients (402 male and 386 female; median age +/- SD, 51.1 +/- 17.2 years; range, 16-91 years) were examined by appendiceal transabdominal sonography with tissue harmonic imaging. The detection rate, outer appendiceal diameter, intraluminal content, and location of the appendix were estimated. The overall normal appendix was separated into appendix-visualized and appendix-not-visualized groups, which were then examined for the relationship with abdominal wall thickness, body mass index (in kilograms per square meter), age, and sex. RESULTS: The normal appendix was detected in 388 (49.2%) of 788 patients. The outer appendiceal diameter +/- SD was 4.27 +/- 1.2 mm (range, 1.0-11.1 mm). In 291 (75%) of the 388 patients, appendices could be depicted in the intra-luminal gas during sonography. The location of the appendix was classified according to the appendiceal tip, which was found to be abdominal in 37 (9.5%), pelvic in 291 (75%), retrocecal in 23 (6.0%), and a midline extension in 37 (9.5%). In both body mass index and abdominal wall thickness, significant differences were found between appendix-visualized and appendix-not-visualized cases (P < .05). There was no significant difference in age (P = .37) or sex (P = .23) between appendix-visualized and appendix-not-visualized cases. CONCLUSIONS: The results show that the normal adult appendix can be revealed by sonographic visualization in a large series of asymptomatic patients.     

阑尾粪石征在急性阑尾炎CT诊断中的价值

目的探讨阑尾粪石征在多层螺旋CT(MSCT)诊断急性阑尾炎中的价值。方法回顾性分析60例经手术和病理证实的急性阑尾炎患者的CT表现。结果 60例急性阑尾炎患者中主要的CT征象有:阑尾粪石征36例(60.0%),阑尾肿胀伴阑尾周围炎(无阑尾粪石征)15例(25.0%),回盲部周围炎6例(10.0%),阑尾炎伴盲肠周围脓肿形成3例(5.0%),提示穿孔1例。所有患者均行急诊阑尾切除术,术后病理诊断为急性阑尾炎。结论阑尾粪石征在MSCT对急性阑尾炎的影像诊断中有着十分重要的意义。     

Synchronous mucinous tumors of the ovary and the appendix associated with pseudomyxoma peritonei: CT findings

Background: To present the computed tomographic (CT) findings of synchronous mucinous tumors of the ovary and the appendix associated with pseudomyxoma peritonei (PMP). Methods: Imaging studies, mainly abdominal CT scans, of three women aged 49–75 years were reviewed. Attention was directed to the ovarian masses, peritoneal seeding, and the presence of an appendiceal mucocele. Results: The ovarian tumors and the appendiceal mucocele were clearly demonstrated in two cases, and they were part of the extensive PMP in the third patient. Ascites was found in all cases, with internal septation in one. Associated scalloping of the liver margins and hypodense peritoneal implants, with extensive bowel involvement, were seen in another one. Pathologically, there was one case of right ovarian mucinous cystadenoma and villous adenoma of the appendix, one case of right ovarian and appendiceal mucinous cystadenocarcinoma, and one case of bilateral metastatic ovarian implants of appendiceal mucinous cystadenocarcinoma. PMP was found in all. In the case with benign tumors of the ovary and the appendix, the PMP was classified as a benign mucinous spillage. This patient returned 33 months after surgery with PMP, in which epithelial cells were found. Conclusions: Radiologists should be familiar with the clinical occurrence of synchronous mucinous tumors of the ovary and the appendix associated with PMP and with the typical CT findings of the latter two entities. Alternatively, when the imaging findings suggest ovarian cystic tumor with PMP, the radiologist should be alerted to the probability of a clinically unsuspected appendiceal mucocele and should search for it. Received: 10 August 1999/Accepted: 22 September 1999     

急性阑尾炎16排螺旋CT低剂量腹部平扫并重建的CT征象及临床价值分析

目的:对急性阑尾炎16排螺旋CT低剂量腹部平扫并重建的CT征象及临床价值进行分析研究。材料与方法:随机抽取80例经手术病理证实的急性阑尾炎患者作为研究对象,所有患者均具有完整的CT检查资料,对其进行回顾性分析。结果:本组研究中CT诊断的符合率为95.0%;CT直接征象为管壁增厚,阑尾增粗,阑尾内结石,间接征象为阑尾周围脓肿,邻近回盲部肠壁增厚,阑尾浆膜面模糊及阑尾周围炎性改变。结论:16排螺旋CT低剂量腹部平扫及重建可清晰显示急性阑尾及其周围病灶,在临床诊断急性阑尾炎方面确诊率较高,其具有积极的应用价值。     

多排螺旋CT诊断急性阑尾炎的价值分析

目的分析急性阑尾炎多排螺旋CT表现并探讨多排螺旋CT（MSCT）对急性阑尾炎诊断价值。方法回顾性分析15例经手术病理证实的急性阑尾炎及阑尾炎并发症的MSCT表现及分型,采用16排CT对全腹部进行多期扫描,利用多平面重组（MPR）、曲面重组（CPR）及最大密度投影（MIP）等后处理技术进行观察。结果急性化脓性阑尾炎3例,急性坏疽穿孔性阑尾炎及阑尾脓肿12例,发生并发症10例,并发症均发生于阑尾坏疽穿孔或阑尾溶解病例,其中盆腔脓肿4例,腹腔脓肿3例,盆腔、腹腔均见脓肿1例,粘连性肠梗阻4例,腹腔脓肿伴输尿管炎性狭窄1例,阑尾脓肿累及盆腹壁致腹壁瘘、合并肓肠癌1例。术前14例正确诊断急性化脓性阑尾炎或阑尾脓肿,CT诊断率达93．3％。但急性化脓性阑尾炎与急性坏疽性阑尾炎无穿孔时鉴别困难。结论急性阑尾炎MSCT表现具有一定特征性,对急性阑尾炎诊断具有重要价值。     

Beyond appendicitis; radiologic review of unusual and rare pathology of the appendix

Appendicitis is a very common cause of acute abdominal pathology, however, many other pathologic conditions of the appendix can be diagnosed utilizing CT. Examples of these conditions include primary appendiceal neoplasms, secondary inflammation of the appendix, stump appendicitis, endometriosis, appendicitis within a hernia, appendiceal diverticulosis and intussusception and intraluminal foreign bodies. The purpose of this article is to review appendiceal pathology outside of acute appendicitis, describe corresponding imaging findings on CT, and to illustrate various CT findings of appendiceal disease with representative cases.