儿童急性阑尾炎的病理分型与超声声像对照分析

目的通过对儿童急性阑尾炎的病理分型与超声声像对照分析,总结儿童急性阑尾炎不同病理分型的超声直接与间接声像特点。方法回顾性统计413例经病理证实的儿童急性阑尾炎和200例正常病例的超声诊断结果,参照阑尾炎病理分型,分析不同病理类型阑尾炎的超声表现以及它们的主要差异。结论超声检查对不同病理类型急性阑尾炎具有重要的鉴别诊断意义。超声测量阑尾最大外径对鉴别单纯性阑尾炎与正常阑尾及其他类型阑尾炎具有统计学意义,鉴别化脓性阑尾炎与坏疽性阑尾炎具有统计学意义,鉴别坏疽性阑尾炎与阑尾周围脓肿差异无统计学意义。超声观察管壁层次结构、管壁连续性、管腔内回声及粪石、周围系膜网膜增厚程度、阑尾周围低回声等特征性表现对鉴别不同类型阑尾炎具有统计学意义。

Comparison and Analysis of Pathological Types and Ultrasonic Characteristics for Acute Appendicitis in Children

Objective The characteristics of direct and indirect ultrasonography of acute appendicitis in different pathological subtypes were summarized by comparing the pathological subtypes of acute appendicitis in children with the ultrasonography.Methods The ultrasonic diagnosis results of 413 children with acute appendicitis confirmed by pathology and 200 cases of normal appendix were retrospectively analyzed,and the ultrasonic manifestations of different pathological types of appendicitis were analyzed by referring to the pathological classification of appendicitis,and the ultrasonic manifestations of different pathological types of appendicitis were compared.Meanwhile,were randomly selected for control analysis.Conclusions Different pathological types of acute appendicitis have different ultrasound diagnosis rate.Ultrasonic measurement of the maximum external diameter of the appendix has statistical significance in distinguishing simple appendicitis from normal appendicitis and other types of appendicitis,which has also statistical significance in differentiating suppurative appendicitis from gangrenous appendicitis.However,there was no significant difference in the differential diagnosis of gangrenous appendicitis and periappendiceal abscess.Ultrasonic observation of the characteristics of the wall hierarchy,wall continuity,intraluminal echo and coprolites,the thickening degree of the surrounding mesangial omentum,and periappendiceal hypoecho has statistical significance for the identification of different types of appendicitis.