MSCT对老年人不典型阑尾炎的诊断价值  

Value of Multi Slice CT in the Diagnosis of Elderly Patients with Atypical Appendicitis

作　　者：陈海荣[1] 杨军[1] 周嘉[1] 孙超[1] 

机构地区：[1]上海市长宁区中心医院影像科,200336

出　　处：《临床放射学杂志》2012年第10期1499-1501,共3页Journal of Clinical Radiology

基　　金：上海市医学重点专科建设项目资助(编号:05II025)

摘　　要：目的探讨多层螺旋CT(MSCT)对老年人不典型阑尾炎的诊断价值。方法搜集32例年龄>60岁,临床首诊非急性阑尾炎的病例,而经MSCT诊断为急性阑尾炎,并且均经手术及病理证实。回顾性分析其CT表现及特征。结果 32例急性阑尾炎患者中,单纯性阑尾炎5例,化脓性阑尾炎伴阑尾周围炎18例,坏疽伴穿孔性阑尾炎7例,阑尾脓肿2例,其中,阑尾腔内肠石19例,肠石位于阑尾腔外1例,并发腹膜炎3例,结肠肿瘤2例。结论老年人急性阑尾炎的临床症状和体征大多不典型,易误诊。MSCT平扫及图像后处理技术的联合应用,能直观地显示阑尾的形态及病理改变,在对老年人急性阑尾炎快速、准确的诊断中,有重要的临床应用价值。Objective To evaluate multi slice CT（MSCT） in the diagnosis of elderly patients with atypical appendicitis.Methods 32 patients of over 60 years old with clinical diagnosis of non-acute appendicitis firstly,but MSCT diagnosis of acute appendicitis were enrolled in this study.And they were confirmed by surgery and pathology.The CT images of performance and characteristics were retrospectively analyzed.Results Of 32 patients,there were 5 simple acute appendicitis,18 suppurative appendicitis with peri appendiceal inflammation,7 gangrene associated with perforation of appendicitis,2 appendiceal abscess,in which 19 cases had the appendix of intraluminal intestinal stone,intestinal stone was located outside of the cavity in 1 cases,three cases was complicated with peritonitis,colon tumor in 2 cases.Conclusion The clinical signs and symptoms of elderly patients with acute appendicitis are mostly atypical,the disease is very easy to misdiagnose.The images at visual display as well as the morphological and pathological changes of the appendix could be directly displayed on MSCT plain scanning and image processing technique,which provided significant information in the rapid and accurate diagnosis of elderly patients with acute appendicitis.

关 键 词：体层摄影术 X线计算机 老年人 不典型 阑尾炎 

分 类 号：R656.8[医药卫生—外科学]