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目的比较64排螺旋CT与超声诊断急性阑尾炎的临床价值。方法选择56例经手术病理或临床确诊为急性阑尾炎的患者为研究对象,所有患者入院后均接受超声阑尾检查和中下腹部64排螺旋CT检查,比较二者对于急性阑尾炎的诊断准确率。结果 56例患者均经手术病理或者临床确诊为急性阑尾炎,其中轻型急性阑尾炎(即急性单纯性阑尾炎)24例,重型急性阑尾炎32例(其中化脓性阑尾炎27例,坏疽性阑尾炎5例)。24例轻型急性阑尾炎患者螺旋CT发现阳性20例,超声检查阳性13例,诊断准确率明显升高(83.3%vs 54.2%,χ~2=5.736);32例重型急性阑尾炎螺旋CT发现阳性32例,超声检查阳性26例,诊断准确率明显升高(100.0%vs 81.3,χ~2=4.253)。螺旋CT对于轻型急性阑尾炎、重型急性阑尾炎的诊断准确性和总诊断率均明显高于超声检查组,尤其是对于轻型急性阑尾炎的诊断准确率尤其明显升高,差异均有统计学意义(均P<0.05)。结论64排螺旋CT诊断急性阑尾炎的准确性高于超声检查,尤其是对于轻型急性阑尾炎的诊断准确性明显优于超声检查,值得在临床中推广应用。
Objective To compare the clinical value of 64-slice spiral CT and ultrasound in the diagnosis of acute appendicitis. Methods Fifty-six patients with pathologically confirmed or clinically diagnosed acute appendicitis were enrolled in this study. All patients were admitted to the hospital with ultrasound appendectomy and mid-lower abdomen 64-slice spiral CT examination. The diagnostic accuracy of the two methods was compared with that of acute appendicitis. Results All the 56 patients were diagnosed as acute appendicitis by pathology or clinical diagnosis. There were 24 cases of mild acute appendicitis (acute simple appendicitis), 32 cases of severe acute appendicitis (27 cases of suppurative appendicitis and 5 cases of gangrenous appendicitis). Twenty - four cases of mild acute appendicitis were positive in spiral CT, 13 cases were positive in ultrasound examination, the diagnostic accuracy was significantly higher (83.3% vs 54.2%, χ ~ 2 = 5.736); 32 cases of severe acute appendicitis were positive in spiral CT , Ultrasound examination in 26 cases, the diagnostic accuracy was significantly higher (100.0% vs 81.3, χ ~ 2 = 4.253). Spiral CT for the diagnosis of mild acute appendicitis, severe acute appendicitis, the diagnostic accuracy and the total diagnostic rate were significantly higher than the ultrasound group, especially for the light acute appendicitis diagnostic accuracy was significantly higher, the differences were statistically significant (P <0.05). Conclusion The accuracy of 64-slice spiral CT in the diagnosis of acute appendicitis is higher than that of ultrasonography. Especially, the diagnostic accuracy of 64-slice spiral CT is superior to ultrasonography in diagnosing acute appendicitis, which is worth popularizing in clinic.