64排螺旋CT重建技术在急性阑尾炎诊断中的应用价值

摘要

Objective To investigate the effectiveness of 64-slice spiral CT reconstruction technique in diagnosis of acute appendicitis. Methods Retrospective analysis of 64-slice spiral CT scan images was performed on 60 patients who underwent abdominal 64-slice spiral CT scans and were confirmed through clinical pathology as acute appendicitis sufferers. After multi-planar and curve reconstruction of all the images in the workstation, observation and analysis of appendicitis were made on the size, morphology and surrounding changes. Results Among 60 patients with acute appendicitis, 21 cases were found acute simple appendicitis, 32 superlative appendicitis, 5 appendiceal abscess, 2 appendiceal perforation. Two kinds of features - direct and indirect features could be gained from 64-slice spiral CT findings. Direct features include thickened and enlarged appendicitis(diameter> 6 mm), thickened wall of the appendicitis, appendicitis calculus. Indirect features included inflammation, abscess or inflammatory mass around the appendicitis, free intraperitoneal gas and swelling local lymph nodes. Conclusion Acute appendicitis had typical features in its CT iamges. Application of 64-slice spiral CT reconstruction techniques could have a better reveal of appendicitis and its surrounding circumstances, which significantly improved the diagnosis of appendicitis and was of great application value.%　　目的探讨64排螺旋CT重建技术在急性阑尾炎诊断中的应用价值。方法对60例经临床病理证实的急性阑尾炎患者的64排螺旋CT扫描资料进行回顾性分析，所有患者行全腹部64排螺旋平扫，所得图像在工作站进行多平面及曲面重建，对阑尾的大小、形态及周围改变进行观察分析。结果60例资料中，急性单纯性阑尾炎21例、化脓性阑尾炎32例、阑尾脓肿5例、阑尾穿孔2例。64排螺旋CT直接征象为阑尾增粗、增大（直径＞6 mm），阑尾壁增厚，阑尾结石；间接征象为阑尾周围炎、阑尾周围脓肿或周围炎性包块、腹腔游离气体、局部淋巴结肿大。结论急性阑尾炎有典型的CT表现，64排螺旋CT重建技术能更好的显示阑尾及其周围情况，明显提高对阑尾炎的诊断能力，有很高的应用价值。