多层螺旋CT检查在阑尾炎术前中的诊断价值

目的]探讨多层螺旋CT（MSCT）检查在阑尾炎术前中的诊断价值.方法]选择经手术病理证实的阑尾炎患者99例,术前均行常规盆腔CT扫描和冠状、矢状、平行髂骨和垂直髂骨四个方位的多平面重建（MPR）,分析其影像学特征.结果]阑尾显示率90.9%（90/99）;阑尾平均直径14.0（6.2～26.6）mm,显示阑尾的最佳截面：冠状位59例,矢状位19例,垂直髂骨7例,平行髂骨4例,轴位1例;阑尾位置：回肠后位30例,盲肠后位6例,回肠前位11例,盲肠前位4例,盲肠下位39例;阑尾梗阻部位：根部86例,中间4例,可见明确粪石43例,未见明确粪石47例;阑尾周围炎性浸润56例,无炎性浸润30例,脓肿形成13例,合并穿孔1例.结论]MSCT检查在阑尾炎术前中的诊断价值高,值得临床推广应用.

Clinical Value of Mult-slice Spiral CT Examination in Preoperative Diagnosis of Appendicitis

Objective]To explore the value of multi slice spiral CT（MSCT） in the diagnosis of appendicitis be fore operation. Methods] Ninety nine patients with appendicitis confirmed by surgery were chosen. Before the opera-tion, all patients performed routine pelvic CT scan and multiplanar reformation（MPR） including sagittal, coronal, parallel ilium and vertical ilium were reconstructed. Imaging characteristics were analyzed. Results] Appendix ap-pearance rate was 90. 9%（90/99）. The mean diameter of appendix was 14.0mm（6.2-26.6ram）. The best appear- ance plane of appendix were coronal view in 59 patients, sagittal view in 19 patients, vertical ilium view in 7 patients, parallel ilium view in 4 patients and axial view in a patient. Appendix located on retroileal in 30 patients, cecum retro-position in 6 patients, ileum anteposition in 11 patients, cecum anteposition in 4 patients and cecum hypostasy in 39 patients. Appendix obstruction occurred in appendix root in 86 patients and middle appendix in 4 patients. Appen diceal fecalith was found in 43 patients. No appendiceal feealith was found in 47 patients. Inflammatory infiltration a-round appendix was seen in 56 patients. No inflammatory infiltration was seen in 30 patients. There were 13 patients with abscess and a patient with perforation. Conclusion] MSCT has high value in preoperative diagnosis of appendi-citis, so it is worthy of clinical promotion and application.