64排螺旋CT多平面及曲面重建在急性阑尾炎诊断中的价值  

The Value of 64-slice Spiral CT Multiplanar and Curved Reconstruction in the Diagnosis of Acute Appendicitis

作　　者：马振中 Ma Zhenzhong(The Fourth Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210031)

机构地区：[1]南京医科大学第四附属医院,江苏南京210031

出　　处：《现代医用影像学》2021年第3期400-403,共4页Modern Medical Imageology

摘　　要：目的:探讨64排螺旋CT多平面重建(MPR)联合曲面重建(CPR)技术对急性阑尾炎的诊断价值。方法:回顾性收集2018年5月至2020年5月至本院急诊疑似急性阑尾炎患者100例,所有患者术前均执行CT常规轴扫及MPR、CPR后处理重建,以手术病理结果为"金标准",统计分析MRP、CPR及联合两种重建技术诊断急性阑尾炎的灵敏度、特异度及准确度。结果:在100例疑似患者中,经手术病理证实80例为急性阑尾炎,20例为非急性阑尾炎。在20例非急性阑尾炎患者中,5例右侧附件炎,10例盲肠憩室炎,2例Crohn病,3例正常。MPR诊断急性阑尾炎的灵敏度为75.0%(60/80),特异度为50.0%(10/20),准确度为70.0%(70/100);CPR诊断急性阑尾炎的灵敏度为81.2%(65/80),特异度为60.0%(12/20),准确度为77.0%(77/100);MPR联合CPR诊断急性阑尾炎的灵敏度为87.5%(70/80),特异度为75.0%(15/20),准确度为85.0%(85/100)。MPR联合CPR诊断急性阑尾炎的灵敏度、特异度及准确度均高于MPR或CPR单一诊断,差异有统计学意义(P<0.05)。结论:MPR联合CPR可互相弥补单一诊断中的不足,明显提高对急性阑尾炎的诊断效能,为临床及时诊疗提供可靠依据。Objective:To explore the diagnostic value of 64-slice spiral CT multiplanar reconstruction(MPR) combined with curved surface reconstruction(CPR) in acute appendicitis.Methods:100 patients with suspected acute appendicitis in our hospital from May 2018 to May 2020 were collected retrospectively. All patients underwent CT conventional axial scan and post-processing reconstruction of MPR and CPR before operation. The sensitivity, specificity and accuracy of MRP, CPR and combined reconstruction techniques in diagnosis of acute appendicitis were analyzed statistically.Results:Among 100 suspected patients, 80 cases were confirmed as acute appendicitis and 20 cases as non-acute appendicitis by operation and pathology. Among 20 patients with non-acute appendicitis, 5 cases were right adnexitis, 10 cases were cecal diverticulitis, 2 cases were Crohn’s disease and 3 cases were normal. The sensitivity, specificity and accuracy of MPR in diagnosing acute appendicitis were 75.0%(60/80), 50.0%(10/20) and 70.0%(70/100). The sensitivity, specificity and accuracy of CPR in diagnosing acute appendicitis were 81.2%(65/80), 60.0%(12/20) and 77.0%(77/100). The sensitivity, specificity and accuracy of MPR combined with CPR in the diagnosis of acute appendicitis were 87.5%(70/80), 75.0%(15/20) and 85.0%(85/100). The sensitivity, specificity and accuracy of MPR combined with CPR in diagnosis of acute appendicitis were higher than those of MPR or CPR alone, and the difference was statistically significant(P<0.05).Conclusion:MPR combined with CPR can make up for the deficiency of single diagnosis, obviously improve the diagnostic efficiency of acute appendicitis, and provide reliable basis for timely clinical diagnosis and treatment.

关 键 词：急性阑尾炎 多平面重建 曲面重建 CT 诊断 

分 类 号：R656.8[医药卫生—外科学] R816.5[医药卫生—临床医学]