多排螺旋CT在不典型急性阑尾炎诊断中的应用

目的探讨多排螺旋CT在不典型急性阑尾炎诊断中的意义。方法对56例不典型急性阑尾炎患者CT影像、治疗结果进行回顾性分析。结果 56例中,男20例,女36例,年龄17～88岁,平均(51.5±15.7)岁。发病时间1 h～7 d。螺旋CT均显示阑尾图像。CT影像表现为阑尾水肿增粗、管壁增厚33例,其中23例伴有阑尾周围渗出、积液。9例阑尾周围脓肿,5例阑尾腔内发现肠石。15例发现回盲部肠壁增厚,2例发现升结肠肿物。5例显示正常阑尾影像,其中2例发现右附件肿物,2例小肠节段性肠壁增厚,1例肠系膜淋巴结肿大。CT扫描结合临床诊断急性阑尾炎51例,行手术治疗47例,均经病理组织学检查证实。5例排除阑尾炎。结论多排螺旋CT阑尾影像特征对不典型急性阑尾炎诊断和治疗选择有重要价值。

Multidetector row CT in diagnosis of atypical acute appendicitis

Objective To explore the significance of multidetector row CT in diagnosis of atypical acute appendicitis. Methods Fifty six cases of atypical acute appendicitis of CT imaging and their treatment results were retrospectively analyzed. Results In 56 cases,there were 20 males,36 females,aged from 17 to 88 years old,average age was(51.5±15.7) years old.Onset time was 1h-7d.Appendix images were obtained by multidetector row CT scanning in all the patients.Appendix images in 33 cases showed appendix wall edema and thickening,among them there were 23 cases with periappendiceal exudate fluid.Appendix abscess was found in 9 cases,intestinal stone of appendix cavity in 5 cases,15 cases of ileocecal wall thickening,2 cases with ascending colon tumors.Normal images of appendix were showed in 5 cases and were ruled out appendicitis diagnosis.Of them,there were 2 of right ovarian tumors,2 with segmental small bowel wall thickening,1 had enlargement of mesenteric lymph nodes.Acute appendicitis was diagnosed in 51 cases according to the CT image and the clinical sign.Appendectomy was performed for 47 patients,and histopathological examination?confirmed acute appendicitis.5 cases ruled out appendicitis. Conclusion Multidetector row CT has significant value for diagnosis and treatment of atypical acute appendicitis.