阑尾黏液性疾病与急性阑尾炎的超声鉴别及临床分析  

Value of ultrasound and clinical features in differential diagnosis of appendiceal mucocele and acute appendicitis

作　　者：王栋华[1] 杜联芳[1] 陈红燕[2] 李凡[1] 邢玲溪 韩明丽[2] 陈永其[3] 高峰[1] 刘阳[1] 史秋生[1] 

机构地区：[1]上海交通大学附属第一人民医院超声科,200080 [2]复旦大学附属闵行医院超声科 [3]复旦大学附属闵行医院病理科

出　　处：《中华超声影像学杂志》2016年第5期409-412,共4页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金(81271596,81571679)National Natural Science Foundation of China

摘　　要：目的 探讨阑尾黏液性疾病与急性阑尾炎鉴别的超声图像表现及临床特征.方法 回顾性分析36例阑尾黏液性疾病（包括24例肿瘤性黏液疾病和12例非肿瘤性黏液疾病）和69例急性阑尾炎患者（包括19例复杂性阑尾炎和50例非复杂性阑尾炎）的临床资料,分组比较阑尾的最大内径、阑尾壁情况（是否显示、是否增厚、是否伴结节或钙化）、患者的发病年龄、性别、入院时血常规白细胞计数、癌胚抗原.结果 与急性阑尾炎患者比较,阑尾黏液性疾病患者发病年龄和阑尾最大内径更大,白细胞正常和癌胚抗原升高更多见,阑尾壁多清晰显示,可伴结节或钙化（P＜0.05）;其中肿瘤性黏液疾病与复杂性阑尾炎比较,阑尾壁显示情况、发病年龄、白细胞和癌胚抗原等指标组间差异有统计学意义（P＜0.05）,而与非复杂性阑尾炎比较,非肿瘤性黏液疾病患者仅发病年龄偏大（P＜0.05）.结论 肿瘤性黏液疾病的超声表现及临床指标有一定的特异性,掌握其特征有助于正确诊断及鉴别诊断该病,非肿瘤性黏液疾病与非复杂性阑尾炎的超声鉴别存在困难,术前难以准确诊断.Objective To investigate the ultrasonic manifestations and clinical features in differential diagnosis of appendiceal mucocele and acute appendicitis.Methods Thirty-six cases of appendiceal mucocele （24 cases of appendiceal neoplastic mucocele and 12 cases of appendiceal non-neoplastic mucocele） and 69 patients with acute appendicitis （19 cases of complicated appendicitis and 50 cases of uncomplicated appendicitis） were retrospective analyzed.The maximum diameter,the wall in the appendix （whether displaying,whether thickening,whether with nodules or calcification）,age,sex,white blood count （WBC）,carcinoembryonic antigen （CEA） were compared between groups.Results Comparing with acute appendicitis,the appendiceal mucocele＆#39;s average onset age was older and the largest diameter was larger,WBC and CEA increased more commonly,the wall usually can be displayed clearly,with nodules or calcification （P 〈0.05）.The difference between the appendiceal neoplastic mucocele and complicated appendicitis on the displaying rate of appendiceal wall,the age,the WBC and CEA was statistically significant.The onset age of the appendiceal non-neoplastic mucocele was older than uncomplicated appendicitis （P 〈0.05）.Conclusions Appendiceal neoplastic mucocele has characters,grasping its characteristics of ultrasonographic and combination with clinical features can help correct diagnosis and differential diagnosis of the disease.The sonographic findings of the appendiceal non-neoplastic mucocele are similar to those of the uncomplicated appendicitis,it is difficult to identify before operation.

关 键 词：超声检查 阑尾炎 阑尾肿瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R656.8[医药卫生—诊断学] R735.36[医药卫生—临床医学]