CT与超声在急性阑尾炎诊断中的应用价值
摘要
目的分析CT与超声在急性阑尾炎诊断中的应用价值。方法选取医院2017年1月-2018年6月收治的急性阑尾炎患者595例,均行CT及超声诊断,以病理诊断作为金标准,比较两种诊断方法的诊断结果,并分析图像特征。结果 595例患者均行病理活检,均确诊为急性阑尾炎,其中单纯性阑尾炎246例(41.34%);化脓性阑尾炎276例(46.39%);坏疽性阑尾炎39例(6.55%);阑尾周围脓肿34例(5.71%)。CT与超声诊断急性阑尾炎的诊断符合率比较差异无统计学意义(P>0.05)。结论 CT、超声在诊断急性阑尾炎中诊断价值均较高,但CT的电离辐射容易导致癌变,具有一定的局限性,因此临床可将超声作为急性阑尾炎诊断的首选方法,在超声诊断不确定时,再介入CT诊断,提高临床诊断准确率。
引文
[1] 夏禹,黄瑛,富聪聪,等.超声与CT诊断小儿急慢性阑尾炎的对比分析[J].中国临床医学影像杂志,2014,25(11):793-796.
[2] Sauvain M O,Slankamenac K,Muller M K,et al.Delaying surgery to perform CT scans for suspected appendicitis decreases the rate of negative appendectomies without increasing the rate of perforation nor postoperative complications[J].Langenbecks Arch Surg,2016,401(5):643-649.DOI:10.1007/s00423-016-1444-x.
[3] 陈丽山,黄维,刘莉萍,等.多层螺旋CT与超声对急性阑尾炎的诊断价值比较[J].中国CT和MRI杂志,2015,13(11):101-103.DOI:10.3969/j.issn.1672-5131.2015.11.030.
[4] Benabbas R,Hanna M,Shah J,et al.Diagnostic Accuracy of History,Physical Examination,Laboratory Tests,and Point-of-care Ultrasound for Pediatric Acute Appendicitis in the Emergency Department:A Systematic Review and Meta-analysis[J].Acad Emerg Med,2017,24(5):523-551.DOI:10.1111/acem.13181.
[5] 杨兵,王嵩,史鹏丽.CT与超声检查诊断各种病理类型阑尾炎的对比研究[J].东南大学学报(医学版),2015,34(2):269-272.DOI:10.3969/j.issn.1671-6264.2015.02.024.
[6] 倪健坤,戴鸿志.多排螺旋CT与超声在诊断不典型症状急性阑尾炎中的对比研究[J].右江医学,2014,42(2):160-163.DOI:10.3969/j.issn.1003-1383.2014.02.008.
[7] 黄雪.超声与64排螺旋CT平扫检查在诊断急性阑尾炎中的应用价值[J].现代诊断与治疗,2016,27(1):167-168.
[8] 林月洁,戴淼磊.超声与CT诊断小儿急慢性阑尾炎的临床分析[J].医学影像学杂志,2017,27(1):178-180.
[9] 曹林丽,厉玛萱萱,乔忠云,等.128排螺旋CT与超声在急性阑尾炎分型中的比较[J].罕少疾病杂志,2017,24(1):41-43.DOI:10.3969/j.issn.1009-3257.2017.01.017.
[10] 陈俊枝.用超声检查法和CT检查法诊断急性阑尾炎的效果对比[J].当代医药论丛,2016,14(1):41-43.
[11] Jones R P,Jeffrey R B,Shah B R,et al.Journal Club:the Alvarado score as a method for reducing the number of CT studies when appendiceal ultrasound fails to visualize the appendix in adults[J].Ajr Am J Roentgenol,2015,204(3):519-526.DOI:10.2214/AJR.14.12864.
[12] 赵国庆.多层螺旋CT与超声对急性阑尾炎的临床诊断价值对比[J].内蒙古中医药,2017,36(11):85-86.
[13] 冯战国.多排螺旋CT与超声检查诊断急性阑尾炎的对比分析[J].临床医学研究与实践,2016,1(26):135-136.DOI:10.3969/j.issn.2096-1413.2016.26.071.
[14] Atema JJ,Gans SL,Van RA,et al.Comparison of Imaging Strategies with Conditional versus Immediate Contrast-Enhanced Computed Tomography in Patients with Clinical Suspicion of Acute Appendicitis[J].Eur Radiol,2015,25(8):2445-2452.DOI:10.1007/s00330-015-3648-9.
[2] Sauvain M O,Slankamenac K,Muller M K,et al.Delaying surgery to perform CT scans for suspected appendicitis decreases the rate of negative appendectomies without increasing the rate of perforation nor postoperative complications[J].Langenbecks Arch Surg,2016,401(5):643-649.DOI:10.1007/s00423-016-1444-x.
[3] 陈丽山,黄维,刘莉萍,等.多层螺旋CT与超声对急性阑尾炎的诊断价值比较[J].中国CT和MRI杂志,2015,13(11):101-103.DOI:10.3969/j.issn.1672-5131.2015.11.030.
[4] Benabbas R,Hanna M,Shah J,et al.Diagnostic Accuracy of History,Physical Examination,Laboratory Tests,and Point-of-care Ultrasound for Pediatric Acute Appendicitis in the Emergency Department:A Systematic Review and Meta-analysis[J].Acad Emerg Med,2017,24(5):523-551.DOI:10.1111/acem.13181.
[5] 杨兵,王嵩,史鹏丽.CT与超声检查诊断各种病理类型阑尾炎的对比研究[J].东南大学学报(医学版),2015,34(2):269-272.DOI:10.3969/j.issn.1671-6264.2015.02.024.
[6] 倪健坤,戴鸿志.多排螺旋CT与超声在诊断不典型症状急性阑尾炎中的对比研究[J].右江医学,2014,42(2):160-163.DOI:10.3969/j.issn.1003-1383.2014.02.008.
[7] 黄雪.超声与64排螺旋CT平扫检查在诊断急性阑尾炎中的应用价值[J].现代诊断与治疗,2016,27(1):167-168.
[8] 林月洁,戴淼磊.超声与CT诊断小儿急慢性阑尾炎的临床分析[J].医学影像学杂志,2017,27(1):178-180.
[9] 曹林丽,厉玛萱萱,乔忠云,等.128排螺旋CT与超声在急性阑尾炎分型中的比较[J].罕少疾病杂志,2017,24(1):41-43.DOI:10.3969/j.issn.1009-3257.2017.01.017.
[10] 陈俊枝.用超声检查法和CT检查法诊断急性阑尾炎的效果对比[J].当代医药论丛,2016,14(1):41-43.
[11] Jones R P,Jeffrey R B,Shah B R,et al.Journal Club:the Alvarado score as a method for reducing the number of CT studies when appendiceal ultrasound fails to visualize the appendix in adults[J].Ajr Am J Roentgenol,2015,204(3):519-526.DOI:10.2214/AJR.14.12864.
[12] 赵国庆.多层螺旋CT与超声对急性阑尾炎的临床诊断价值对比[J].内蒙古中医药,2017,36(11):85-86.
[13] 冯战国.多排螺旋CT与超声检查诊断急性阑尾炎的对比分析[J].临床医学研究与实践,2016,1(26):135-136.DOI:10.3969/j.issn.2096-1413.2016.26.071.
[14] Atema JJ,Gans SL,Van RA,et al.Comparison of Imaging Strategies with Conditional versus Immediate Contrast-Enhanced Computed Tomography in Patients with Clinical Suspicion of Acute Appendicitis[J].Eur Radiol,2015,25(8):2445-2452.DOI:10.1007/s00330-015-3648-9.