急性阑尾炎的CT漏诊及误诊分析

目的:探讨急性阑尾炎CT诊断漏诊、误诊的原因.材料和方法:对23例经手术及病理证实的急性阑尾炎病例的术前CT资料进行回顾性分析,重点对CT漏诊、误诊原因进行分析.结果:23例急性阑尾炎中,14例(60.9%)CT于术前确定急性阑尾炎诊断,8例(34.8%)漏诊,1例(4.3%)误诊.8例漏诊中,5例诊断时对急性阑尾炎CT表现认识不足或完全忽略;2例分别为单纯性阑尾炎及慢性阑尾炎急性发作,CT表现轻微;3例右下腹缺乏脂肪比衬,影像学诊断困难;2例CT扫描范围不足,未完全覆盖病变区域.1例阑尾脓肿因忽略脓腔中粪石征而误诊.结论:熟悉急性阑尾炎的各种CT表现、改善扫描方法并密切结合临床应可帮助提高术前诊断率.

Analysis of Misinterpretation of Acute Appendicitis on CT

Purpose:To analyze the reasons causing misinterpretation of acute appendici tis on CT. Materials and Methods: We retrospectively analyzed the preoperative C T data of 23 cases of acute appendicitis proved by surgery and pathology.Reasons causing misinterpretation of CT were intentionally analyzed. Results: In the 23 cases, 14 diagnosis (60.9%)were confirmed, 8 (34.8%)missing and 1 (4.3%)misdiagnosing. In the 8 cases with CT missing correct diagnosis pre -operation, the abnormal CT signs were not sufficiently realized or completely neglected in 5 cases; CT signs were mild in 2 cases which were simple acute app endicitis and chronic appendicitis with acute onset respectively; CT diagnoses w ere difficult to made in 3 cases lack of peritoneal fat; CT scans did not cover the whole area of lesion in 2 cases. 1 case of appendiceal abscess was misdiagn osed without noticing the fecalith in the abscess cavity. Conclusion: Being fami liar with CT signs of acute appendicitis, improving CT scanning method and combi ning clinical history tightly would improve correct CT diagnosis before operation.