高频加压超声诊断急性阑尾炎的临床应用价值

目的：探讨高频超声探头及局部加压对急性阑尾炎诊断的临床应用价值。方法：采用超声高频探头及局部加压法检查急性阑尾炎237例，分析了急性单纯性阑尾炎，化脓坏疽穿孔性阑尾炎和阑尾周围脓肿以及伴发症的声像图特征，并与手术结果对照。结果：237例均行手术治疗。急性单纯性阑尾炎47例，超声诊断符合率为85．1％(40／47)；急性化脓坏疽穿孔性阑尾炎169例，超声诊断符合率为98．8％(167／169)；阑尾周围脓肿21例，超声诊断符合率为100％。与手术对照超声诊断总符合率为96．2％。结论：临床疑急性阑尾炎采用超声高频探头及局部加压扫查，阳性显示率高，具有重要临床诊断价值。     

高频超声诊断急性阑尾炎的临床价值

目的：探讨高频超声探头检查在急性阑尾炎诊断中的临床价值。方法：对。130例临床疑诊急性阑尾炎患者的超声检查结果进行临床随访、分析，其中116例经手术及病理证实。结果：高频超声诊断急性单纯性阑尾炎符合率93．5％；急性化脓性阑尾炎诊断符合率95．3％；急性坏疽性阑尾炎诊断符合率90．9％；阑尾周围脓肿诊断符合率100％；阑尾粪石诊断符合率100％；阑尾穿孔诊断率41．2％；总假阴性率为3．1％；总误诊率为1．5％。结论：高频超声对急性阑尾炎检查简单、快速、无损伤、费用低，而且准确率高，有较大的临床价值，可作为急性阑尾炎影像学检查的首选方法。     

急性阑尾炎的超声诊断

目的探讨B超对急性阑尾炎的声像图特征及诊断价值。方法在60例经手术治疗证实为急性阑尾炎患者的超声检查中,通过高低频探头相结合的方法,将其声像图特征和术后病理结果对照。结果阑尾炎的超声诊断符合率为85%。结论B超在急性阑尾炎的诊断中具有重要作用,可为急性阑尾炎的分型提供参考。     

高、低频率超声联合对高原急性阑尾炎分型诊断200例分析

目的 探讨高、低频超声联合对高原急性急性阑尾炎进行分型诊断的临床意义。方法应用低频率探头和高频率探头检查200例急性阑尾炎患者并与手术、病理结果进行对照分析。结果使用低频率探头检查诊断符合率34％;高、低频率探头联合应用检查诊断符合率90．5％,高、低频率超声探头联合应用诊断符合率明显高于低频率超声探头（P〈0．01）。结论高、低频率超声探头联合检查对提高急性阑尾炎用分型诊断符合率具有临床意义。     

急性阑尾炎渗出期B超与术后的比较

临床中应用B超诊断阑尾周围脓肿较为简单、可靠，但对于急性阑尾炎的B超诊断仍缺乏必要的探讨。自1992年1月至1997年1月，对184例急性阑尾炎术前B超诊断，并就B超检查情况与术中所见进行对照，以确定B超对急性阑尾炎的诊断价值。1临床资料184例中，男76例，女108例，年龄6～71岁，平均年龄35岁。急诊手术161例（87．主％），非急诊手术16例（8．6％），非手术治疗7例（3．9％）。184例中，有转移性右下腹痛者57例（31％），无转移性疼痛仅有右下腹疼痛者127例（69％），其中有腹膜刺激征者29例（15．8％）。184例均做B超检查，探头频率为…     

彩色多普勒超声在急性阑尾炎中的应用价值（附110例分析）

目的：分析急性阑尾炎（包括不同病理类型）的彩色多普勒超声声像图并评价其诊断价值。方法对110例手术病理证实的急性阑尾炎患者进行超声声像图的分析。结果110例急性阑尾炎中,超声确诊100例,漏诊10例,总符合率91.1％,其中急性单纯性阑尾炎符合率88.7％（55／62）,化脓性阑尾炎符合率93.7％（30／32）,坏疽性阑尾炎符合率92.6％（11／12）,阑尾周围脓肿符合率100％（4例）。结论彩色多普勒超声能根据超声声像图特征进行急性阑尾炎的诊断及分型,对诊断急性阑尾炎有较高的准确性,可为临床诊断和治疗阑尾炎提供可靠的依据。     

急性阑尾炎的超声诊断

目的探讨超声在急性阑尾炎诊断中的应用。方法回顾性分析经手术、病理证实的128例急性阑尾炎的超声图象。结果128例中正确诊断117例,诊断符合率为91．4％,误、诊4例,漏诊7例,误、漏诊率8．6％。结论超声应作为急性阑尾炎诊断和鉴别的常规检查。     

B型超声在老年急性阑尾炎诊断中的作用

目的：探讨B型超声在老年急性阑尾炎诊断中的作用。方法：采用回顾性分析我院收治的60例老年急性阑尾炎的B超诊断资料与临床诊断比较。结果：B超诊断急性阑尾炎患者中有3例误诊,但是57例急性阑尾炎诊断结果与组织病理学诊断无显著性差异,P〉0.05。结论：B超诊断老年急性阑尾炎具有无创、准确率较高等特点。     

多层螺旋CT与超声对急性阑尾炎患者的临床诊断价值

目的比较分析多层螺旋CT与超声对急性阑尾炎患者的临床诊断价值。方法选取我院收治的63例急性阑尾炎患者作为研究对象,分别进行多层螺旋CT与超声检查,将检查结果与手术病理结果相比较,分析两者的临床诊断价值。结果与手术病理比较,多层螺旋CT对阑尾结构完整可辨、阑尾结构难辨、阑尾结构不清、团块等各型的诊断符合率分别为95.24%、80.00%、100.00%、100.00%。超声的诊断符合率分别为83.33%、66.67%、75.00%、100.00%。多层螺旋CT的总诊断符合率明显高于超声,多层螺旋CT与超声对急性单纯性阑尾炎的诊断符合率分别为100.00%、59.46%。急性化脓性阑尾炎的诊断符合率分别为75.00%、50.00%,急性坏疽性阑尾炎的诊断符合率均为100.00%。多层螺旋CT的诊断符合率明显高于超声,尤其是对急性单纯性阑尾炎的诊断符合率明显高于超声,差异具有统计学意义(P0.05)。结论多层螺旋CT应用于急性阑尾炎的诊断及分型,与临床病理诊断符合率高于超声。典型的CT征象为阑尾直径6mm、阑尾及周围肠壁增厚、存在积液等,为急性阑尾炎的诊断提供参考。     

超声诊断急性阑尾炎临床价值分析

目的：探讨急性阑尾炎超声诊断价值及其与病理分型之间的关系。方法对急性阑尾炎患者的超声检查结果进行对比分析。结果58例患者经手术病理确诊为单纯性阑尾炎40例，化脓性阑尾炎12例，坏疽性阑尾炎6例；超声诊断与分型符合率分别为97．50％、91．67％、100．00％，差异具有统计学意义（ P ＜0．05）。阑尾炎的病理类型：单纯性阑尾炎40例，化脓性阑尾炎12例，坏疽性阑尾炎6例。阑尾增粗、肿大、僵硬、无蠕动，直径在1．0cm以上，有38例，最粗达2．1 cm ；其管壁增厚水肿，呈“双层”或多层改变，内呈低回声，腔内见强回声，阑尾周围可见不等量液性暗区。按照术后病理确诊情况将102例患者分为非阑尾炎组和阑尾炎组，对比两组患者的阑尾直径、长度及管壁厚度可以发现阑尾炎组患者的阑尾直径、长度及管壁厚度均明显大于非阑尾炎组，且差异具有统计学意义。结论急性阑尾炎超声征象有助于各病理分型的鉴别诊断，为临床治疗方案提供依据。     

高低频超声结合在诊断急性阑尾炎中的临床价值

目的:探讨高频超声和低频超声联合应用在诊断急性阑尾炎中的临床价值。方法:对2008年5月～2010年5月我院临床怀疑急性阑尾炎者先行低频超声扫查,然后联合应用高频超声对比扫查。对123例术后病理证实为急性阑尾炎的超声图像进行回顾性分析。结果:低频超声诊出阑尾炎88例,符合率71.5%,低频超声联合高频超声诊出阑尾炎109例,符合率88.6%。阑尾长轴切面呈腊肠样盲端结构,短轴切面呈"同心圆"征。结论:高、低频超声联合应用能有效提高急性阑尾炎的超声诊断符合率,为临床治疗方案的判定提供重要的参考依据,在诊断急性阑尾炎中有重要的临床意义。     

多种频率超声探头联合应用在急性阑尾炎诊断中的价值探讨

目的探讨凸阵腹部探头、高频线阵探头、多种频率超声探头联合在急性阑尾炎诊断中的临床价值。方法回顾性分析我院69例经术后病理证实为急性阑尾炎患者的超声声像图特征,术前这些患者分别采用单独应用凸阵腹部探头,单独应用高频线阵探头及多种频率超声探头联合应用的方法进行了超声检查。结果单独应用凸阵腹部探头检查超声诊断符合率为54%,单独应用高频线阵探头检查超声诊断符合率为65%,2种探头联合应用超声诊断符合率为93%,明显高于仅用一种超声探头进行诊断,比较差异有统计学意义(P<0.05)。结论多种频率超声探头联合应用对急性阑尾炎的诊断价值更高。     

超声在急性阑尾炎诊断中的应用

目的：探讨超声在急性阑尾炎诊断中的临床应用价值。方法：回顾性分析150例经手术病理证实为急性阑尾炎的患者的超声探查情况。结果：150例患者中经超声直接或间接提示为急性阑尾炎的病例数为121例,诊断准确率为80．67％;漏诊29例,漏诊率为19．33％。结论：超声为一种安全可靠、实用快捷、无创性的检查,在急性阑尾炎的诊断中具有较高的准确性,可作为诊断和鉴别诊断急性阑尾炎的首选影像学诊断方法。     

Imaging of acute appendicitis and its impact on negative appendectomy and perforation rates: the St. Paul's experience.

PURPOSE: Preoperative imaging of acute appendicitis is widely practised. The aim of this study is to determine the prevalence of preoperative imaging of acute appendicitis in our institution and its effect on the negative appendectomy rate and perforation rates. METHODS: We undertook a retrospective review of all patients who underwent appendectomy from January 2000 to December 2004. All available preoperative ultrasound (US), computed tomography (CT), and pathology results were reviewed. RESULTS: A total of 380 appendectomies were performed over this time period for the preoperative diagnosis of acute appendicitis. Fifty-nine patients had histologically normal appendices, giving an overall negative appendectomy rate of 15.5%. Overall, patients who had preoperative imaging showed a lower negative appendectomy rate (11.4%) than did those without imaging (22.2%). Without preoperative imaging, women had a higher negative appendectomy rate (34.3%) than did men (17.4%). Reduction in the negative appendectomy rate was demonstrated with preoperative imaging in both sexes (16.7% and 5.7%, respectively). Also demonstrated is a definite trend toward increased use of preoperative CT and away from US as the sole preoperative imaging modality. This is associated with a reduced negative appendectomy rate. CONCLUSIONS: The increased use of preoperative imaging, particularly CT, is associated with a decreased negative appendectomy rate and a decreased perforation rate at our institution.     

Ultrasonography in patients with suspected acute appendicitis: a prospective study

The diagnostic accuracy of high-resolution real-time ultrasonography was prospectively studied in 240 patients admitted to the hospital with suspected acute appendicitis. The criteria for ultrasound diagnosis of appendicitis included a sausage-shaped, aperistaltic, hypoechoic structure when imaged along its longitudinal axis, with a target-like appearance on transverse section. The ultrasonographic findings were correlated with surgical-pathological outcome in 82 cases with proven appendicitis, with laparotomy findings in another 21 patients and with clinical follow-up in the remainder. The overall sensitivity, specificity and accuracy of ultrasonography in the diagnosis of acute appendicitis were 78%, 92% and 87%, respectively. The positive predictive value was 84% and the negative predictive value was 88%. Ultrasonography may significantly improve the diagnostic accuracy in patients with suspected acute appendicitis and should be performed in all patients in whom the clinical diagnosis is equivocal. The ultrasonographic findings must be interpreted in light of the clinical findings.     

ACR Appropriateness Criteria Right Lower Quadrant Pain—Suspected Appendicitis

The diagnostic imaging of patients presenting with right lower quadrant pain and suspected appendicitis may be organized according to age and gender and to the presence or absence of "classic" signs and symptoms of acute appendicitis. Among adult patients presenting with clinical signs of acute appendicitis, the sensitivity and specificity of CT are greater than those of ultrasound, with improved performance when CT is performed with intravenous contrast. The use of rectal contrast has been associated with decreased time in the emergency department. Computed tomography has also been shown to reduce cost and negative appendectomy rates. Both CT and ultrasound are also effective in the identification of causes of right lower quadrant pain unrelated to appendicitis. Among pediatric patients, the sensitivity and specificity of graded-compression ultrasound can approach those of CT, without the use of ionizing radiation. Performing MRI after inconclusive ultrasound in pregnant patients has been associated with sensitivity and specificity of 80% to 86% and 97% to 99%, respectively. The ACR Appropriateness Criteria(?) are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.