彩色多普勒超声对急性阑尾炎的诊断价值

目的探讨彩色超声对急性阑尾炎的诊断价值。方法回顾分析经手术病理证实急性阑尾炎患者66例,术前应用彩色超声检查右下腹,发现异常回声,重点测量其大小范围并观察其周边、内部血流信号及腹腔局部积液情况,着重分析总结急性阑尾炎声像图特征。结果本组66例急性阑尾炎中,其中单纯性阑尾炎18例、化脓性阑尾炎33例、坏疽性阑尾炎5例,阑尾周围脓肿2例,慢性阑尾炎急性发作8例。超声确诊55例,漏诊8例,误诊3例。超声诊断符合率83.3%。它们共有的主要基本声像图特征为右下腹不均匀低回声或混合性回声,该区不规则,血流较丰富,探头局部加压疼痛明显。结论彩色超声对急性阑尾炎有较高的诊断价值和临床意义。

Value of color Doppler ultrasound in the diagnosis of acute appendicitis

Objective To investigate the value of color Doppler ultrasound in the diagnosis of acute appendicitis.Methods Ultrasonagraphic findings in 66 patients with acute appendicitis confirmed by surgery and pathology were analyzed retrospectively.Color Doppler ultrasound was used to examine abdominal right lower quadrant before surgery.If abnormal sonogram was detected,intensive measurement of its size,interior and peripheral blood flow signals and abdominal fluid collection were performed.Color Doppler ultrasound features of acute appendicitis were analyzed and summarized.Results Of the 66 patients with acute appendicitis,there were acute simple appendicitis（18 cases）,acute suppurative appendicitis（33 cases）,acute gangrenous appendicitis（5 cases）,periappendiceal abscess（2 cases） and acute episode chronic appendicitis（8 cases）.There were 55 cases diagnosed correctly.,8 cases missed and 3 cases misdiagnosed by color Doppler ultrasound.The total diagnostic coincidence rate was 83.3%.The main basic features on color Doppler ultrasound were an inhomogeneous hypoechogenic mass or a mixed echogenic mass at right lower quadrant with irregular margin and abundant blood flow signals,and the ache was evident when the probe pressed.Conclusion Color Doppler ultrasound is valuable in the diagnosis of acute appendicitis clinically.