多层螺旋CT在急性阑尾炎诊断中的应用价值

目的：探讨多层螺旋 CT 在急性阑尾炎诊断中的应用价值。方法选取30例急性阑尾炎患者作为研究组和30例无任何症状的健康成人作为对照组进行多层螺旋 CT 检查。测量阑尾外径,观察阑尾位置,阑尾腔内液体密度、气体密度,阑尾周围脂肪密度改变及腹膜增厚、腹腔积液等并发表现。结果急性阑尾炎平均阑尾外径为(9.78±2.33)mm,健康成年人平均阑尾外径为(5.05±0.53)mm,二者差异有统计学意义(t=24.85,P <0.01)。阑尾周围组织脂肪密度增高、毛糙25例,占83.33%,CT 值约-40~20 HU；阑尾周围有渗出性改变伴腹膜增厚13例,占43.33%；阑尾管壁增厚、水肿29例,占96.67%；阑尾腔内高密度粪石9例,占30.00%；阑尾炎合并肠梗阻1例(占3.33%)；阑尾炎患者并发有腹膜增厚,占80.00%；合并有腹腔积液,占23.33%。结论多层螺旋 CT 全腹部平扫可应用于急性阑尾炎的诊断；当阑尾外径 CT 表现为≥6 mm,阑尾腔积液、腔内粪石、周缘脂肪密度增高、腹膜增厚、腹腔积液等征象,可提示阑尾炎诊断。

The application value of MSCT in diagnosis of acute appendicitis

Objective To discuss the application value of MSCT in the diagnosis of acute appendicitis.Methods 30 patients with appendicitis were enrolled as a research group,meanwhile 30 healthy adults without any diseases were as a control group.Some MSCT findings were observed or measured including diameter and position of appendix,fluid and gas density in appendix cavity, periappendicural fat density and peritoneal thickening,ascites and so on.Results The outside diameter of acute appendicitis appen-dix was (9.78±2.33)mm on average,whereas the diameter of normal adults appendix was (5.05±0.53)mm,exhibiting a signifi-cant difference (t=24.85,P <0.01).Rough periappendicural fat with increased density in 25 patients (83.33%)with the CT value of about -40 to 20 HU,exudation and peritoneal thickening around the appendix in 13 (43.33%),thickening and edematous appen-dix walls in 29 (96.67%),fecal stone in the appendix cavity with high density in 9(30.00%),the appendicitis in combination with intestinal obstruction in 1 (3.33%),and the appendicitis with peritoneal thickening in 80.00% and with peritoneal effusion in 23.33%were found in the study.Conclusion Full abdominal MSCT can help to the diagnosis of acute appendicitis,and some MSCT findings can be useful for the diagnosis including the appendix diameter≥6 mm,appendix cavity effusion,lumen stone,peripheral increased adipose density and peritoneal effusion.