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。

VALUE OF MULTI-SLICE SPIRAL CT 3D RECONSTRUCTION IN THE DIAGNOSIS OF ACUTE APPENDICITIS

Objective To evaluate the diagnostic value of multi-slice spiral CT 3D reconstruction for acute appendicitis. Methods Fifty-eight patients with suspected diagnosis of acute appendicitis were enrolled and examined using multi-slice spiral CT scanning. The CT images were conveyed to workstation for multiplanar and contour reconstruction （MPR/CPR）. The CT manifestations were analyzed and compared with surgical and pathological findings.
Results Of the 58 patients,53 were diagnosed as having acute appendicitis, two with ascending colon carcinoma, two with right-side inguinal hernia, and one was false-negative. The main signs of acute appendicitis on multiple-slice CT were enlarged appendix （〉6 mm） （96.2%）, appendicular lithiasis （17.0%）, thickening of the wall of ileocecal junction （30.1%）, periappendiceal inflammation（60.4%）, abscess （15.1%）, and perforation of appendix （9.4%）. Conclusion Acute appendicitis has typical signs on CT,3D reconstruction postprocessing technology can display the appendix and its surrounding tissues in every way, which is of a higher clinical value in the diagnosis of acute appendicitis.