增强CT在急性腹膜炎鉴别诊断中的临床价值  

Clinical value of enhanced CT in the differential diagnosis of acute peritonitis

作　　者：刘月 张丽娟 Liu Yue;Zhang Lijuan(Department of Imaging,Kaifeng Hospital of Traditional Chinese Medicine,Henan 475000,China)

机构地区：[1]河南省开封市中医院影像科,475000

出　　处：《实用医学影像杂志》2023年第4期249-252,共4页Journal of Practical Medical Imaging

摘　　要：目的分析增强CT在急性腹膜炎鉴别诊断中的临床价值。方法选择本院2017年12月至2022年12月住院的106例急性腹膜炎患者,根据手术病理活检穿刺诊断结果将其分为2组,50例结核性腹膜炎(TBP)患者设为TBP组,56例感染性腹膜炎(SP)患者设为SP组,均给予增强CT检查,比较2组腹腔积液密度、腹腔积液量、CT影像学征象,绘制受试者工作特征曲线(ROC),计算曲线下面积(AUC),分析增强CT鉴别诊断急性腹膜炎的灵敏度、特异度。结果TBP组腹腔积液密度≤20(32.0%)、>20(68.0%)与SP组(30.4%、69.6%)比较,差异无统计学意义(P>0.05)。TBP组腹腔积液中少量率(80.0%)高于SP组(35.7%),差异有统计学意义(P<0.05)。TBP组结节样(24.0%)、宽带样征象(22.0%)与SP组(26.8%、28.6%)比较,差异无统计学意义(P>0.05);TBP组均匀率(54.0%)高于SP组(26.8%),差异有统计学意义(P<0.05),TBP组未见异常率(0)低于SP组(17.9%),差异有统计学意义(P<0.05)。增强CT鉴别诊断急性腹膜炎的AUC(95%CI)是0.876(0.701,0.924),灵敏度是92.9%、特异度是90.1%。结论增强CT在TBP、SP鉴别诊断中灵敏度及特异度较高,可通过腹腔积液量及CT影像学征象对疾病作出诊断,具有一定的参考价值。Objective To analyze the clinical value of enhanced CT in the differential diagnosis of acute peritonitis.Methods A total of 106 patients with acute peritonitis admitted to our hospital from December 2017 to December 2022 were selected and divided into 2 groups according to the biopsy results of surgical pathology.Fiffy patients with tuberculous peritonitis(TBP)were assigned to the TBP group,and 56 patients with infectious peritonitis(SP)were assigned to the SP group.All patients were given enhanced CT examination.Ascites density,abdominal water volume and CT imaging signs of the two groups were compared,the receiver operating curve(ROC)was drawn,the area under curve(AUC)was calculated,and sensitivity and specificity of enhanced CT in the differential diagnosis of acute peritonitis were analyzed.Results The differences of the rate of ascites density≤20(32.0%)and>20(68.0%)in the TBP group and that in the SP group(30.4%and 69.6%)were not significant(P>0.05).The percentage of small amount in ascites in TBP group(80.0%)was higher than that in the SP group(35.7%,P<0.05).Nodular(24.0%)and wide-band(22.0%)signs in TBP group were not different from those in the SP group(26.8%,28.6%)(P>0.05).The uniform rate in the TBP group(54.0%)was higher than that in the SP group(26.8%)(P<0.05),and the rate of no abnormality in the TBP group(0)was lower than that in the SP group(17.9%)(P<0.05).The AUC(95%CI)for differential diagnosis of acute peritonitis with enhanced CT was 0.876(0.701,0.924),sensitivity was 92.9%,and specificity was 90.1%.Conclusion Enhanced CT has high sensitivity and specificity in the differential diagnosis of TBP and SP.It can be used to diagnose diseases by abdominal water volume and CT imaging signs,which has certain reference value.

关 键 词：体层摄影术 X线计算机 腹膜炎 结核性 感染性腹膜炎 鉴别诊断 

分 类 号：R572.2[医药卫生—消化系统]