64层螺旋CT平扫和增强诊断成人急性阑尾炎的比较  

Diagnosis of acute appendicifits by 64-slice spiral CT:comparison of plain scan and enhanced scan

作　　者：杨峰[1] 查云飞[2] 周静然[1] 叶明[1] 

机构地区：[1]湖北医药学院附属襄阳医院放射科,441000 [2]武汉大学人民医院放射科,武汉430060

出　　处：《放射学实践》2013年第12期1275-1278,共4页Radiologic Practice

摘　　要：目的:探讨64层CT平扫和增强扫描对急性阑尾炎的诊断价值。方法:采用GE LightSpeed 64层CT机,对98例临床怀疑急性阑尾炎的患者行CT平扫和增强扫描,采用多平面重组(MPR)、曲面重组(CPR)、最大密度投影(MIP)技术进行图像后处理,分析单纯平扫及平扫结合增强扫描诊断急性阑尾炎的敏感度、特异度、阳性预测值、阴性预测值和符合率。结果:98例中54例行手术治疗,7例经手术病理证实为正常阑尾,47例为急性阑尾炎:阑尾充血、水肿4例,单纯性阑尾炎12例,阑尾炎伴阑尾周围炎17例,阑尾坏疽、穿孔伴周围炎8例,阑尾脓肿6例。CT平扫诊断急性阑尾炎46例,其中3例为假阳性;平扫结合增强扫描正确诊断45例,假阴性2例。两者诊断急性阑尾炎的敏感度、特异度、阳性预测值、阴性预测值及符合率分别为91.5%、57.1%、93.5%、50.0%和87.0%以及95.7%、100.0%、100.0%、77.8%和96.3%。两者对急性阑尾炎的诊断符合率差异无统计学意义(P>0.05)。结论:64层螺旋CT平扫可以快速准确地显示急性阑尾炎及其并发症,而且操作简便、费用少及辐射剂量低,可以作为拟诊急性阑尾炎而临床表现不典型患者的首选检查方法。Objective： To assess the difference in the diagnosis of acute appendicitis between 64-slice spiral CT （MSCT） plain scan and enhanced scan. Methods： 98 patients with clinical suspected acute appendicitis were scanned with 64- slice spiral CT using continuous volume scanning including plain and enhanced scans. The source images were reformation into three-dimensional images using the technique of multiplanar reconstruction （MPR）, curved planar reconstruction （CPR） and maximum intensity projection （MIP）. The CT images of plain scan only and plain scan with enhanced were ret- rospectively analyzed. Results：Of the 98 patients,47 of 54 patients who underwent surgery had pathologically proven acute appendicitis. 46 patients were diagnosed as acute appendicitis by plain scan and 3 of them had false negative findings. 45 pa- tients were diagnosed as acute appendicitis by plain scan with enhanced. The sensitivity, specificity, positive predictive value, negative predictive value,and accuracy of them were 91.5% ,57. 1% ,93.5%,50.0% ,87.0% and 95.7%,100.0%,100. 0%,77.8 % and 96.3 %respectively. There was no significant difference between them （P〉0.05）. Conclusion： 64-slice spi- ral CT plain scan can quickly and accurately display acute appendicitis and its complication,and has the advantages of simple operation without contrast medium allergic ricks, with less costs and low radiation dose. It can be used as the preferred method for the patients who were suspected acute appendicitis with atypical clinical manifestations.

关 键 词：阑尾炎 体层摄影术 X线计算机 图像处理 计算机辅助 

分 类 号：R656.8[医药卫生—外科学] R814.42[医药卫生—临床医学]