利用CT平扫观察阑尾壁包埋征对复杂性阑尾炎的诊断价值研究  

Study on the Diagnostic Value of Using CT Plain Scan to Observe the Appendiceal Wall Flooding Sign for Complicated Appendicitis

作　　者：吴磊[1] 季丹[1] 张志国[1] 陆建东[1] 茅旭平[1] WU Lei;JI Dan;ZHANG Zhi-guo;LU Jian-dong;MAO Xu-ping(Department of Radiology,Zhangjiagang Hospital of Traditional Chinese Medicine(Zhangjiagang Hospital Affiliated to Yangzhou University),Zhangjiagang 215600,Jiangsu Province,China)

机构地区：[1]张家港市中医医院、南京中医药大学附属张家港医院,江苏张家港215600

出　　处：《中国CT和MRI杂志》2024年第12期154-156,159,共4页Chinese Journal of CT and MRI

基　　金：苏州市“科教兴卫”青年科技项目(KJXW2023064);苏州市卫生青年骨干人才“全国导师制”培训项目(Qngg2024035);江苏医药职业学院校地协同创新研究项目(20239604)。

摘　　要：目的探讨利用CT平扫观察阑尾壁包埋征对复杂性阑尾炎的诊断价值。方法回顾性分析2020年7月1日至2022年12月31日期间经手术及病理证实的急性阑尾炎患者114例的CT征象,其中复杂性阑尾炎31例,非复杂性阑尾炎83例。观察CT征象包括:阑尾壁包埋征、阑尾外径、脓肿、蜂窝织炎、阑尾腔外气体和阑尾腔外粪石。采用单因素和多因素logistic回归分析来评价这些征象对复杂性阑尾炎的诊断价值。结果在单因素分析中,与复杂性阑尾炎显著相关的危险因素有:年龄(P=0.003)、发病时间(P=0.002)、阑尾外径(P<0.001)、阑尾壁包埋征(P<0.001)、蜂窝织炎(P<0.001)及阑尾腔外气体(P=0.001)。然而,在多因素分析中,只有阑尾壁包埋征(OR=98.356,P<0.001)和年龄(OR=1.069,P=0.014)是复杂性阑尾炎的独立危险因素。阑尾壁包埋征用于复杂性阑尾炎诊断中AUC曲线下面积为0.894。结论通过CT平扫观察阑尾壁包埋征对复杂性阑尾炎具有重要诊断价值。Objective To investigate the diagnostic value of observing the appendiceal wall flooding sign using CT plain scan for complicated appendicitis.Methods Retrospective analysis of 114 patients with surgically and pathologically confirmed acute appendicitis,including 31 cases of complicated appendicitis and 83 cases of uncomplicated appendicitis,between July 1,2020 and December 31,2022.Preoperative CT imaging examinations including the appendiceal wall flooding sign,diameter of appendix,abscess,phlegmon,extraluminal air,and extraluminal appendicolith were documented.Univariate and multivariate logistic regression analyses were used to evaluate the relative value of these parameters as potential predictors of complicated appendicitis.Results Features significantly related to complicated appendicitis at univariate analysis were age(P=0.003),disease time(P=0.002),diameter of appendix(P<0.001),the appendiceal wall flooding sign(P<0.001),phlegmon(P<0.001),and extraluminal air(P=0.001).At multivariate analysis,the appendiceal wall flooding sign(odds ratio,98.356,P<0.001),as well as age(odds ratio,1.069,P=0.014),were independent risk factors for complicated appendicitis.The appendiceal wall flooding sign for complicated appendicitis showed an area under the receiver operating characteristic curve of 0.894.Conclusion The observation of the appendiceal wall flooding sign by CT plain scan has important diagnostic value for complicated appendicitis.

关 键 词：急性阑尾炎 复杂性阑尾炎 阑尾壁包埋征 体层摄影技术 X线计算机 

分 类 号：R574.61[医药卫生—消化系统]