64层螺旋CT各向同性冠状位重组图像对急性阑尾炎的诊断价值研究  

The value in diagnosis of acute appendicitis with coronal reformations from isotropic voxels with 64 slice multi-detector row CT

作　　者：高旭宁[1] 许茂盛[1] 卢良骥[1] 丁国苗[1] 王世威[1] 

机构地区：[1]浙江中医药大学附属第一医院放射科,浙江杭州310006

出　　处：《医学影像学杂志》2010年第9期1341-1344,共4页Journal of Medical Imaging

摘　　要：目的:评价64层CT各向同性冠状位重组图像在诊断急性阑尾炎的辅助价值。方法:回顾性分析50例怀疑急性阑尾炎患者,均行64层CT平扫+增强扫描。扫描范围包括全腹部。由3位放射科医生独立观察横断位及横断位+冠状位图像,将阅片所发现的部分阑尾、全部阑尾、阑尾壁增厚、肠腔扩张、炎症积液和阑尾炎按可信度分为5级,敏感度、特异度由每个阅片者诊断决定并进行统计学检验。结果:3位阅片者使用横断位观察敏感性、特异性的平均值为92%和89%,而结合冠状位重组图像的敏感性,特异性为97%和95%。使用横断位结合冠状位图像观察阑尾部分或全长,肠壁增厚,阑尾周围炎症较横断位图像的可信度高。冠状位重组图像对排除阑尾炎有辅助价值。结论:64层CT横断位结合冠状位图像比单独使用横断位图像有较大敏感性、特异性,冠状位图像增加了识别阑尾炎和诊断阑尾炎的可信度,提高了诊断阑尾炎的诊断率。Objective：To assess retrospectively the adjuvant value of coronal reformation from isotropic voxels obtained with 64 slice multi-detector row computed tomography （64MSCT） in patients with suspected acute appendicitis. Methods：Fifty consecutive patients with suspected appendicitis were retrospectively analyzed. Patients were performed with conventional scan and enhancement scan. Scanning filed included abdomen and pelvis. Three blinded radiologist interpreted transverse scans alone and then coronal scans and transverse scans. Confidence in view of portion or entire appendix,inflammation,fluid,and appendicitis was scored with 1～5 scale. Sensitivity and specificity were determined by each reader and compared by means of singed rate test. Results：Mean sensitivity and specificity for all three readers together were 92%,89% for transverse alone and were 97%,95% for combined transverse with coronal reformation respectively. Confidence in view of Portion or entire appendix,wall thickening,periappendicural inflammation were higher for combined transverse and coronal reformation than for transverse alone. Coronal reformation helped finding appendicitis and aided diagnosis. Conclusion：64 MSCT transverse plus coronal reformations have higher sensitivity and specificity for diagnosis of appendicitis. Coronal reformations improve confidence in visualization of appendicitis and in diagnosis of appendicitis.

关 键 词：急性阑尾炎 体层摄影术 X线计算机 

分 类 号：R574.61[医药卫生—消化系统] R814.42[医药卫生—内科学]