64层螺旋CT诊断急性阑尾炎病理类型临床价值  

64⁃slice Spiral CT Signs in the Diagnosis of Acute Appendicitis Pathological Subtype

作　　者：钟丽珍 赵仕懂 丘武应 李智锋 刘国文 巢江玲 Zhong Lizhen;Zhao Shidong;Li Zhifeng;Liu Gouwen;Chao Jiangling(Department of Radiology,Fogang People’s Hospital of Guangdong Province,Qingyuan,Guangdong 511600;Department of General Surgery,Fogang People’s Hospital of Guangdong Province,Qingyuan,Guangdong 511600)

机构地区：[1]广东省清远市佛冈县人民医院放射科,广东清远511600 [2]广东省清远市佛冈县人民医院普外科,广东清远511600

出　　处：《现代医用影像学》2024年第8期1474-1477,共4页Modern Medical Imageology

摘　　要：目的:分析64层螺旋CT征象在诊断急性阑尾炎病理类型临床应用价值。材料与方法:选取我院2020年1月至2022年12月期间急性阑尾炎患者120例,所有患者经64层螺旋CT检查后,通过其CT征象诊断分析:阑尾腔径、周围渗出程度、阑尾是否并存粪石、盲肠壁增厚程度、回肓部周围淋巴结,最后与手术后病理对比,分析该类诊断方法临床应用价值。结果:120例急性阑尾炎,通过分析CT征象诊断,其中12例为单纯性阑尾炎,12例为坏疽性阑尾炎,96例为化脓性阑尾炎。其临床特征为,转移右下腹痛63例(52.5%),反跳痛108例(90%),右下腹压痛116例(96.6%),阑尾管径增粗120例(100%),白细胞计数升高106例(88.3%),体温升高50例(50%),中性粒细胞百分比升高105例(87.5%),恶心呕吐75例(62.5%);三种类型急性阑尾炎阑尾管径数据结果对比具有统计学差异(P<0.05)。结论:64层螺旋CT征象对急性阑尾炎病理类型诊断,具有较高临床应用价值,其中阑尾管径大小、体温、中性粒细胞百分比、阑尾周围渗出对三种不同病理类型急性阑尾炎的鉴别诊断具有临床指导意义。Purpose:To analyze the clinical value of 64⁃slice spiral CT signs in the diagnosis of pathological types of acute appendicitis.Materials and Methods:120 patients with acute appendicitis from January 2020 to December 2022 were selected in our hospital.After 64⁃slice spiral CT examination,all patients were diagnosed and analyzed by CT signs:appendix cavity diameter,degree of peripheral exudation,whether appendix coexisted with fecal stone,degree of cecal wall thickening,and lymph nodes around ileocecal junction.Finally,compared with postoperative pathology,the clinical application value of this diagnostic method was analyzed.Results:120 cases of acute appendicitis were diagnosed by analyzing CT signs,including 12 cases of simple appendicitis,12 cases of gangrenous appendicitis,and 96 cases of suppurative appendicitis.The clinical features were metastatic right lower abdominal pain in 63 cases(52.5%),rebound pain in 108 cases(90%),right lower abdominal tenderness in 116 cases(96.6%),thickening of appendiceal diameter in 120 cases(100%),increased white blood cell in 106 cases(88.3%),increased temperature in 50 cases(50%),increased neutrophils percentage in 105 cases(87.5%),nausea and vomiting in 75 cases(62.5%).There were statistical differences in the results of appendix diameter data of three types of acute appendicitis.(P<0.05).Conclusion:The 64⁃slice spiral CT signs are of high clinical value for the diagnosis of the pathologic types of acute appendicitis.The size of the appendiceal diameter,temperature,percentage of neutrophils,and periappendiceal exudate play an important role in the differential diagnosis of the three different pathologic types of acute appendicitis.

关 键 词：64层螺旋CT 急性阑尾炎 病理学 诊断 

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