超声与CT检查对急性阑尾炎的诊断价值  

Diagnostic value of ultrasonography and CT in acute appendicitis

作　　者：卢凯 孙冲[2] 缪娟[2] 周铠博 王伟[3] 杨华[1] 程勇[4] LU Kai;SUN Chong;MIAO Juan;ZHOU Kaibo;WANG Wei;YANG Hua;CHENG Yong(Department of General Surgery,the Fourth People’s Hospital of Zigong,Zigong,Sichuan Province 643000,China;Department of Ultrasound,the Fourth People’s Hospital of Zigong,Zigong,Sichuan Province 643000,China;Department of Radiology,the Fourth People’s Hospital of Zigong,Zigong,Sichuan Province 643000,China;Department of Gastrointestinal Surgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042,China)

机构地区：[1]自贡市第四人民医院普外科,四川自贡643000 [2]自贡市第四人民医院超声科,四川自贡643000 [3]自贡市第四人民医院放射科,四川自贡643000 [4]重庆医科大学附属第一医院胃肠外科,重庆400042

出　　处：《实用放射学杂志》2024年第4期586-589,共4页Journal of Practical Radiology

摘　　要：目的对比研究超声与CT检查对急性阑尾炎的诊断价值。方法回顾性选取279例急性阑尾炎并行急诊手术患者,以术后病理结果为金标准,分析超声、CT检查对不同类型、体质量指数(BMI)急性阑尾炎患者诊断准确性是否存在差异。结果279例确诊急性阑尾炎患者,病理分型中单纯性阑尾炎64例、化脓性阑尾炎127例、坏疽性阑尾炎88例。超声诊断准确性分别为68.75%(44/64)、73.22%(93/127)、81.81%(72/88);CT诊断准确性分别为71.87%(46/64)、82.67%(105/127)、90.90%(80/88),两者在诊断准确性方面无统计学差异(P>0.05)。按患者BMI进行亚组分析显示,对于BMI正常的患者2种检查诊断准确性无差异(P>0.05),而对于超重、肥胖患者,CT的诊断准确性优于超声,有统计学差异(P<0.05)。结论超声和CT检查对不同病理类型的急性阑尾炎诊断准确性无差异,但对于超重和肥胖的急性阑尾炎患者,CT检查的诊断准确性优于超声检查。Objective To compare the diagnostic value of ultrasonography and CT in acute appendicitis.Methods A retrospective analysis was conducted on 279 patients who were diagnosed with acute appendicitis and followed emergency surgery.Patients were divided into different subgroups based on postoperative pathological results and body mass index(BMI),and the pathological results were used as the gold standard to analyze whether there were differences in the diagnostic accuracy of ultrasonography and CT examination for acute appendicitis.Results A total of 279 patients with confirmed acute appendicitis,with 64 cases of simple appendicitis,127 cases of suppurative appendicitis,and 88 cases of gangrenous appendicitis according to pathological classification.The diagnostic accuracy of ultrasonography was 68.75%(44/64),73.22%(93/127),and 81.81%(72/88),respectively.The diagnostic accuracy of CT was 71.87%(46/64),82.67%(105/127),and 90.90%(80/88),respectively.There was no statistically significant difference in diagnostic accuracy between the two examinations(P>0.05).Subgroup analysis based on patient BMI showed that there was no difference in diagnostic accuracy of the two examinations for patients with normal BMI(P>0.05),while for overweight and obese patients,the diagnostic accuracy of CT was better than that of ultrasonography,with a statistical difference(P<0.05).Conclusion There is no difference in the diagnostic accuracy of ultrasonography and CT examinations for acute appendicitis of different pathological types.But for overweight and obese acute appendicitis patients,the diagnostic accuracy of CT examination is superior to ultrasonography.

关 键 词：急性阑尾炎 超声 计算机体层成像 体质量指数 

分 类 号：R574.61[医药卫生—消化系统] R445.1[医药卫生—内科学] R814.42[医药卫生—临床医学]