超声诊断急性阑尾炎的临床价值

为探讨超声对急性阑尾炎的术前诊断价值。回顾性分析79例经手术和(或)病理证实的急性阑尾炎。其声像图表现:1)直接征象:阑尾不同程度肿大,阑尾纵切面显示为数厘米长的腊肠样、管状、手指状或蚯蚓状的低回声或无回声区,不均质。横断面呈“靶环征”或圆形回声。2)间接征象:阑尾内粪石并声影;阑尾炎有渗出或穿孔时周围的无回声区或有沉积物回声;脓肿形成时为右下腹混合性肿块回声;肠管扩张(特别是升结肠扩张);回盲部肠管局限性水肿或肠系膜增厚和大网膜包裹。超声检查简便、可重复性对急性阑尾炎诊断有很大的实用价值,应列为首选的影像检查方法。

Clinical Value of Ultrasound Diagnosis in Acute Appendicitis

Objective To evaluate the value of the preoperative sonographic diagnosis of acute appendicitis.Methods 79 proved acute appendicitis cases were retrospectively studied to estimate the diagnostic value of sonography.Results The direct sign of acute appendicitis was appendicular swelling.Ultrasonography showed low or absence echo on longitudinal section of appendix like sausage,tube,finger or earthworm.The cross section of appendix showed target-like or disk-like echo.The indirect sign included the stercolith in the appendix with sound shadow; periappendicular absence echo or deposit echo when appendicitis complicated with exudation or perforation; mixed swollen echo on the right hypogastric region when abscess formed; dilation of intestine(ascending colon especially); local ileocecal edema or mesenteric thickening and encysted greater omentum.Conclusions Simple and repetitive ultrasonography has great applicable value on diagnosing appendicitis.Ultrasonography is the imaging method of choice for diagnosing acute appendicitis.