超声对急性阑尾炎阑尾周边高回声结构的分析  

Evaluation of the periappendiceal hyperechoic structure on ultrasonography

作　　者：方凡[1] 赵博文[1] 徐海珊[1] 寿金朵[1] 吕江红[1] 汤富刚[1] 唐海林[1] 杨倩[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院超声科,杭州310016

出　　处：《中华超声影像学杂志》2006年第11期824-826,共3页Chinese Journal of Ultrasonography

摘　　要：目的探讨阑尾周边高回声结构的性质,评价其在急性阑尾炎超声诊断中的临床意义。方法对75例急性阑尾炎患者声像图进行回顾性分析,并与手术及病理结果相对照,分析阑尾周边高回声结构与阑尾炎病理及病变现象之间的相互关系。结果75例急性阑尾炎中阑尾周边高回声结构阳性者32例,阴性者43例。阳性者中单纯性阑尾炎2例,化脓性阑尾炎18例,坏疽性阑尾炎12例,分别占各阑尾炎类型总例数的13%(2/15),39%(18/46),86%(12/14),阑尾周边高回声结构阳性率与病理类型间呈正相关关系(r=0.451,P<0.001),阑尾炎越严重,阑尾周边高回声结构阳性率越高。病理结果显示阑尾周边高回声结构阳性病例均伴有阑尾周围炎,且阑尾发生与周围组织粘连及穿孔的比率明显高于阑尾周边高回声结构阴性病例。结论阑尾周边高回声结构是急性阑尾炎超声征象之一,是阑尾周围组织(大网膜、肠系膜脂肪)受炎症浸润发生急性炎性反应的表现,阑尾周边高回声结构阳性提示与周围组织粘连、阑尾穿孔等严重病变可能性大。Objective To evaluate the clinical importance of the periappendiceal hyperechoic structure （PHS） using uhrasonography in patients with acute appendicitis, Methods The sonograms of 75 patients with acute appendicitis were retrospectively reviewed to investigate the correlation between the PHS and the pathologic findings by comparing the PHS with surgical findings and pathologic diagnosis, Results There was a significant correlation between the prevalence of PHS and the pathologic subtypes of acute appendicitis,the positive PHS rates were 13%（2/15）, 39%（18/46）, 86%（12/14） for early, phlegmonous, and gangrenous appendicitis, respectively（ r = 0.451, P 〈0. 001 ） ; the incidence rates of adhesion（ 100% versus 63 % ） and perforation（28 % versus 7 % ） in PHS-positive patients were significantly higher than those in PHS-negative patients（ P 〈0.05）, Conclusions PHS is one of the most important uhrasonographic signs of acute appendicitis, which may reflect spread of inflammation over the periappendiceal tissue and may indicate the possibility of serious inflammation.

关 键 词：超声检查 阑尾炎 阑尾周边高回声结构 

分 类 号：R445.1[医药卫生—影像医学与核医学]