急性阑尾炎CT检查的临床意义
急性,,急性阑尾炎;计算机断层扫描;诊断,1资料与方法,2结果,3讨论,【参考文献】
【摘要】 目的 分析急性阑尾炎的临床、CT特征，探讨CT检查的临床意义。方法 回顾性分析经临床、CT随访和(或)手术、穿刺病理证实的急性阑尾炎45例(男21例，女24例)，年龄38～86岁(平均66岁)。结果 45例中CT诊断为急性阑尾炎可能1例(2.22%)；急性阑尾炎8例(17.78%)；急性阑尾炎并阑尾周围炎14例(31.11%)；急性阑尾炎并穿孔5例(11.11%)；阑尾脓肿13例(28.89%)；阑尾炎性肿块4例(8.89%)。急性阑尾炎的CT直接征象为阑尾肿大增粗(直径>6mm)、阑尾壁增厚和阑尾石，间接征象有阑尾—盲肠周围脂肪内条索影等。临床诊断为急性阑尾炎可能6例；急性阑尾炎21例；阑尾炎包块16例；另有2例因右上腹痛而拟诊胆囊炎，假阴性率为4.44%(2/45)。结论 CT对急性阑尾炎的诊断特别是对临床表现不甚典型的阑尾炎及其并发症的诊断，具有很高准确率。【关键词】 急性阑尾炎;计算机断层扫描;诊断
Clinical significance of CT in acute appendicitis
ZHANG Guoliang,ZHAO Dianhui,WANG wei，et al.Department of Radiology,The Central Hospital,Zhabei District,Shanghai 200070,China
【Abstract】 Objective To investigate the clinical presentations and CT characteristics of acute appendicitis and to discuss the clinery significance of CT in acute appendicitis.Methods 45 patients with acute appendicitis confirmed by CT followup and surgical or biopsy pathology were analysed retrospectively,in which 21 male patients and 24 female patients were included and the average age was 66 years old with the range from 38y to 86y.The clinical and CT datas were analyzed retrospectively.Results Of 45 cases,acute appendicitis in 9 cases;acute appendicitis accompanied with periappendicitis in 14,acute appendicibis accompanied with perforation in 5,appendiceal abscess in 13 and inflammatory mass in 4,were diagnosed by CT.The direct features of acute appendicitis were enlarged appendix (>6mm),thickened wall and appendicolith.And indirect features included clouding or stranding of the pereiappendiceal fat,and et al.2 cases were misdiagnosed accounting for 4.44%(2/45).Conclusion The accuracy of CT in diagnosing acute appendicitis is very high,which is favourable to diagnosis acute appendicitis for suspected patients and complication of acute appendicitis. ......
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