摘要
目的 探讨多层螺旋CT(MSCT)联合血小板参数[血小板计数(PLT)、平均血小板体积(MPV)]在不同病理类型急性阑尾炎(AA)中的诊断价值。方法 回顾性选取2022年1月~2024年12月我院就诊的135例AA患者,根据病理结果分为单纯性AA组(n=25)、化脓性AA(n=100)、坏疽性AA(n=10),全部患者入院后术前均行MSCT检查、PLT、MPV检测,分析MSCT联合PLT、MPV对不同病理类型急性阑尾炎的影像学差异及诊断价值。结果 不同病理类型AA的MSCT征象中粪石嵌顿、盲肠末端壁增厚、局部淋巴结肿大比较差异无统计学意义(P>0.05);坏疽性AA组阑尾直径、阑尾壁厚度依次高于化脓性AA组、单纯性AA组(P<0.05);与化脓性AA组、单纯性AA组相比,坏疽性AA组的阑尾壁外积气比例更高,与单纯性AA组比较,化脓性AA组、坏疽性AA组阑尾周围积液比例更高(P<0.05)。与单纯性AA组相较,化脓性AA组、坏疽性AA组PLT更高、MPV更低(P<0.05)。MSCT征象拟合模型、血小板参数拟合模型以及联合拟合模型诊断AA不同病理类型的曲线下面积(95%CI)为0.860(0.766~0.954)、0.817(0.699~0.935)、0.920(0.848~0.992)。结论 AA具有典型的MSCT征象,为阑尾直径及阑尾壁厚度变大、阑尾壁外有积气、阑尾周围有积液,同时MSCT征象联合PLT、MPV指标能为鉴别不同病理类型的AA提供一种综合判断方案。
Objective To explore the diagnostic value of multi-slice spiral CT(MSCT)combined with platelet parameters[platelet count(PLT),mean platelet volume(MPV)]on different pathological types of acute appendicitis(AA).Methods A total of 135 AA patients who were treated in the hospital from January 2022 to December 2024 were retrospectively selected and divided into simple AA group(n=25),suppurative AA group(n=100)and gangrenous AA group(n=10)according to the pathological results.All patients received preoperative MSCT examination,PLT detection and MPV detection after admission.The imaging differences and diagnostic value of MSCT combined with PLT and MPV on different pathological types of AA were analyzed.Results There were no significant differences in MSCT signs such as fecal impaction,cecal end wall thickening and local lymph node enlargement among different pathological types of AA(P>0.05).The appendix diameter and appendix wall thickness in the gangrenous AA group were successively higher than those in the suppurative AA group and the simple AA group(P<0.05).Compared with the suppurative AA group and the simple AA group,the proportion of pneumatosis outside the appendix wall was higher in the gangrenous AA group,and compared with the simple AA group,the proportion of effusion around the appendix was higher in the suppurative AA group and the gangrenous AA group(P<0.05).The PLT in the suppurative AA group and the gangrenous AA group was higher while the MPV was lower compared to the simple AA group(P<0.05).The areas under the curves of MSCT sign fitting model,platelet parameter fitting model and combined fitting model in the diagnosis of different pathological types of AA were 0.860(95%CI 0.766-0.954),0.817(95%CI 0.699-0.935)and 0.920(95%CI 0.848-0.992)respectively.Conclusion AA has typical MSCT signs,such as enlarged appendix diameter and appendix wall thickness,pneumatosis outside the appendix wall,and effusion around the appendix.In addition,MSCT signs combined with PLT and MPV can provide a comprehensive judgment regimen for differentiating different pathological types of AA.
作者
常灿灿
张振奇
王霞
杨擎
CHANG Cancan;ZHANG Zhenqi;WANG Xia;YANG Qing(Department of Imaging,Bozhou Hospital of Traditional Chinese Medicine,Bozhou 236800,China;Department of Imaging,Anqing Medical Center(Anqing Municipal Hospital),Anhui Medical University,Anqing 246003,China)
出处
《分子影像学杂志》
2025年第9期1174-1179,共6页
Journal of Molecular Imaging
基金
安徽省高等学校科学研究项目(2022AH050701)。
关键词
急性阑尾炎
多层螺旋CT
血小板参数
病理类型
acute appendicitis
multi-slice spiral CT
platelet parameters
pathological types
