儿童急性阑尾炎CT表现特征  

CT findings of acute appendicitis in children

作　　者：梁永强[1] 崔运能[2] 陈锦灿[1] 郭敬深[1] 夏广明[1] LIANG Yongqiang;CUI Yunneng;CHEN Jincan;GUO Jingshen;XIA Guangming(Department of Radiology,Zhaoqing First People's Hospital,Zhaoqing 526000,China;Department of Radiology,Foshan Maternity and Children's Healthcare Hospital,Foshan 528000,China)

机构地区：[1]肇庆市第一人民医院放射影像科,广东肇庆526000 [2]佛山市妇幼保健院放射科,广东佛山528000

出　　处：《实用放射学杂志》2019年第2期267-270,289,共5页Journal of Practical Radiology

摘　　要：目的探讨儿童急性阑尾炎的CT表现,并与成人比较。方法回顾性分析经手术病理证实的33例儿童急性阑尾炎CT及病理资料,并选取76例成人急性阑尾炎作为对照组,分析儿童及成人急性阑尾炎患者阑尾肿大、阑尾粪石、阑尾腔内气体、阑尾腔外气体、回盲部肥厚、阑尾周围脓肿、周围脂肪内条纹征、腹膜增厚等CT征象,同时对病灶进行CT及病理分级,利用χ2检验及非参数检测法对比儿童及成人急性阑尾炎的区别。结果 33例儿童急性阑尾炎患者,阑尾肿大30例(90.9%)、阑尾粪石25例(75.8%)、阑尾腔内气体16例(48.5%)、阑尾腔外气体2例(6.1%)、周围脂肪内条纹征26例(78.8%)、阑尾周围脓肿3例(9.1%)、回盲部肥厚17例(51.5%)、腹膜增厚28例(84.8%)。儿童急性阑尾炎阑尾粪石、腔内气体征象出现率较成人患者高(P<0.05),而阑尾周围脂肪内条纹征、回盲部肥厚较成人患者低(P<0.05),CT分级显示儿童患者急性阑尾炎分级较成人患者低,但病理分级则较严重(P<0.05)。结论与成人患者相比,儿童急性阑尾炎CT上更常见阑尾结石、腔内气体征象,回盲部肥厚、阑尾周围脂肪条纹征相对少见,CT表现可能会低估其病理的严重程度。Objective To explore the CT findings of acute appendicitis in children,and compare with the adults.Methods Thirty-three pediatric acute appendicitis diagnosed by operative pathology were enrolled in the study,while 76 adult patients were chosen as the control group. A prospective analysis of CT findings of children and adult patients was conducted.CT findings included swelling enlarged appendix, appendiceal intraluminal fecalith,appendiceal intraluminal gas,appendiceal extraluminal gas,fat stranding around appendix and adjacent cecal wall thickening.Additionally,the grades of CT and pathology of the lesions were performed.Chi-square and nonparametric tests were used to explore the differences of acute appendicitis CT and pathology findings between children and adults.Results Of 33 pediatric acute appendicitis patients,30 were found to be involved by swelling enlarged appendix(90.9 %),25 by appendiceal intraluminal fecalith (75.8 %),16 by appendiceal intraluminal gas (48.5 %),2 by appendieeal extraluminal gas (6.1%),26 by fat stranding around appendix (78.8 %),3 by periappendiceal abscess (9.1%),17 by adjacent cecal wail thickening (51.5%),and 28 by peritoneal thickening (84.8%).The incidence of appendiceal intraluminal fecalith and appendiceal intraluminal gas were higher than that of adults (P<0.05),while that of fat stranding around appendix and adjacent cecal wall thickening were lower (P<0.05 ).The CT grades of acute appendicitis in children were lower than that in adults,but the pathology grades were more severe (P<0.05).Conclusion Compared to that in adults,the lesions in children exhibites intraluminal fecalith and appendieeal intraluminal gas more commonly,fat stranding around appendix and adjacent cecal wall thickening less commonly.The CT findings may underestamate the severity of the pathology of acute appendicitis in children.

关 键 词：儿童 急性阑尾炎 计算机体层成像 

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