摘要
目的探讨高分辨率CT(HRCT)检查在以肠梗阻为主要表现急性阑尾炎诊断中的应用效能。方法对30例临床疑似以肠梗阻为主要表现急性阑尾炎患者的腹部HRCT图像和腹部X线透视(或者腹部X线平片)结果进行分析,并与手术、病理结果作比较。结果30例患者中,手术、病理诊断为急性阑尾炎引起机械性小肠梗阻者19例(1例急性单纯性阑尾炎、17例急性化脓性阑尾炎、1例急性坏疽性阑尾炎),非阑尾炎源性肠梗阻者11例。以手术、病理结果为金标准,HRCT检查诊断以肠梗阻为主要表现的急性阑尾炎真阳性18例、假阳性1例、真阴性10例、假阴性1例,诊断敏感性为94.74%、特异性为90.91%、准确率为93.33%、阳性预测值为94.74%、阴性预测值为90.91%;X线检查诊断以肠梗阻为主要表现的急性阑尾炎真阳性4例、假阳性2例、真阴性9例、假阴性15例,诊断敏感性为21.05%、特异性为81.82%、准确率为43.33%、阳性预测值为66.67%、阴性预测值为37.50%;HRCT、X线检查诊断以肠梗阻为主要表现急性阑尾炎的敏感性、特异性、准确率、阳性预测值、阴性预测值相比,χ2值分别为18.24、0.39、17.33、1.26、8.67,P值分别<0.05、>0.05、<0.05、>0.05、<0.05。结论HRCT检查对以肠梗阻为主要表现急性阑尾炎诊断具有较高的准确率,而且明显高于X线检查的诊断准确率。
Objective To explore the application efficiency of high resolution CT(HRCT)in the diagnosis of acute appendicitis(AA)mainly manifested by bowel obstruction.Methods The abdominal HRCT images and abdominal Xray fluoroscopy(or plain abdominal X-ray)results of 30 patients with clinical suspicion of AA with bowel obstruction as the main manifestation were analyzed and compared with the results of surgery and pathology.Results Among the 30 patients,19 were diagnosed as mechanical intestinal obstruction caused by AA(1 was acute simple appendicitis,17 were acute suppurative appendicitis,and 1 was acute gangrenous appendicitis),and 11 were non-appendicitis-derived bowel obstruction.The results of surgery and pathology were taken as the gold standard.The HRCT examination diagnosed 18 cases of true positive AA,1 case of false positive AA,10 cases of true negative AA,and 1 case of false negative AA,with bowel obstruction as the main manifestation.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value of CT were 94.74%,90.91%,93.33%,94.74%,and 90.91%,respectively.Four cases of true positive,2 cases of false positive,9 cases of true negative and 15 cases of false negative AA were diagnosed by X-ray.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of X-ray were 21.05%,81.82%,43.33%,66.67%,and 37.50%,respectively.Compared with the sensitivity,specificity,accuracy,positive predictive value and negative predictive value of AA,the chi-square values of HRCT and X-ray examination were 18.24,0.39,17.33,1.26 and 8.67,respectively.The P values were<0.05,>0.05,<0.05,>0.05,and<0.05.Conclusion HRCT examination has a higher accuracy rate for AA with bowel obstruction as the main manifestation,and its accuracy rate of diagnosis is significantly higher than that of X-ray examination.
作者
都基权
焦健
许韫
张鹏
DU Jiquan;JIAO Jian;XU Yun;ZHANG Peng(Shandong Armed Police Corps Hospital,Jinan 250014,China)
出处
《山东医药》
CAS
2020年第9期86-89,共4页
Shandong Medical Journal
作者简介
通信作者:张鹏(E-mail:13698648252@163.com)。
