摘要
目的探讨急性阑尾炎螺旋CT征象的诊断价值。方法回顾性分析经手术病理和随访观察证实的205例阑尾炎患者和100例阑尾正常者的CT资料。观察分析阑尾增大、阑尾壁增厚、阑尾壁强化、阑尾壁强化缺损、阑尾周围脂肪内条纹、盲肠顶局部增厚、阑尾粪石、阑尾腔外积气、阑尾腔外粪石、蜂窝织炎、阑尾腔外积液、阑尾周围脓肿、淋巴结肿大等13项指标,用卡方检验统计学方法选出急性阑尾炎的CT诊断征象,并对这些征象的敏感性和特异性进行评价。结果 13种征象的敏感性和特异性中:阑尾增大(98.5%,98%)、阑尾壁增厚(96%,99%)、阑尾壁强化(97.6%,99%)、阑尾壁强化缺损(6.3%,99%)、阑尾周围脂肪内条纹(99.5%,90%)、盲肠顶肠壁增厚(53.7%,97%)、蜂窝织炎(17.1%,92%)、脓肿(16.6%,95%)8种征象对急性阑尾炎诊断有统计学意义(χ2=282.804、266.897、278.887、4.379、257.254、73.957、4.569、8.090,P<0.05)。结论阑尾增大、阑尾壁增厚、阑尾壁强化、阑尾周围脂肪内条纹4个征象对阑尾炎诊断的敏感性和特异性较高,而阑尾壁强化缺损、盲肠顶肠壁增厚、蜂窝织炎、脓肿4个征象特异性较高,但敏感性较低。
Objective To evaluate the diagnostic value of individual CT signs in appendicitis at helical CT. Methods CT features of 205 patients with surgically proven acute appendicitis and 100 patients with normal appendix were re- viewed retrospectively. Thirteen CT features, including enlarged appendix, appendiceal wall thickening, appendiccal wall enhancement, enhancement defect in appendiceal wall , periappendiceal fat stranding, focal cecal apical thickening, ap- pendicolith （s） , extraluminal air, extraluminal appcndicolith, phlegmon, extraluminal fluid, abscess , lymphadenopathy were analyzed. The CT features that distinguished appendicitis from normal appendix were selected with Chi square test. Sensitivity and specificity of the individual CT signs of appendicitis were evaluated. Results Eight CT findings , inclu- ding enlarged appendix （sensitivity ,98.5% ;specificity,98% ） ,appendiceal wall thickening （sensitivity,96% ;specifici- ty, 99% ） , appendiceal wall enhancement （sensitivity,97.6% ;specificity, 99% ） ,enhancement defect in appendiceal wall （ sensitivity, 6.3% ;specificity ,99% ） , periappendiceal fat stranding （ sensitivity ,99.5% ;specificity,90% ） , focal cecal apical thickening （ sensitivity, 53.7% ; specificity, 97% ） , phlegmon （ sensitivity, 17.1% ; specificity ,92% ） , abscess （ sensitivity , 16.6% ; specificity ,95% ） were found to be significantly different between acute appendicitis and normal ap- pendix （P 〈 0.05 ）. Conclusion The CT findings, included enlarged appendix , appendiceal wall thickening , appendiceal wall enhancement and periappendiceal fat stranding had high sensitivity and specificity for diagnosing appendicitis. The other findings of enhancement defect in appendieeal wall , focal cecal apical thickening , phlegmon , abscess had high specificity but low sensitivity for diagnosing appendicitis.
出处
《临床放射学杂志》
CSCD
北大核心
2014年第6期894-898,共5页
Journal of Clinical Radiology
