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目的探讨高、低频彩色多普勒超声联合应用对急性阑尾炎诊断及分型的价值。方法对236例疑似急性阑尾炎患者,使用2.0~5.0MHz、8.0~14MHz探头进行腹部超声扫查,重点检查右下腹或压痛区域,并联合应用组织谐波、彩色多普勒血流图及能量图。观察阑尾形态、大小、壁层次结构及血流情况,与手术后病理结果进行对照分析。结果236例阑尾炎患者,经手术后病理确诊急性单纯性阑尾炎16例,化脓性阑尾炎159例,坏疽性阑尾炎36例,慢性阑尾炎24例,阑尾脓肿1例。超声确诊急性阑尾炎199例,其中单纯性阑尾炎9例,化脓性阑尾炎143例,坏疽性阑尾炎27例,慢性阑尾炎20例,阳性率84.3%。假阴性37例,占15.7%。结论高、低频彩色多普勒超声联合应用,观察阑尾形态、大小及壁层次结构改变在急性阑尾炎诊断及分型中有其重要价值。
Objective To investigate the value of high and low frequency color Doppler ultrasound in the diagnosis and classification of acute appendicitis. Methods Totally 236 patients with suspected acute appendicitis underwent abdominal ultrasonography with 2.0 ~ 5.0MHz and 8.0 ~ 14MHz probes. The focus of the study was to examine the right lower quadrant or tenderness area. Tissue harmonic, color Doppler flowgraph and energy map . Observed the appendix morphology, size, wall structure and blood flow, and postoperative pathological results were analyzed. Results A total of 236 patients with appendicitis were diagnosed as acute simple appendicitis by pathology after operation, 159 cases of suppurative appendicitis, 36 cases of gangrenous appendicitis, 24 cases of chronic appendicitis and 1 case of appendix abscess. 199 cases of acute appendicitis were diagnosed by ultrasound, including 9 cases of simple appendicitis, 143 cases of suppurative appendicitis, 27 cases of gangrenous appendicitis and 20 cases of chronic appendicitis. The positive rate was 84.3%. False negative in 37 cases, accounting for 15.7%. Conclusions Combined use of high and low frequency color Doppler ultrasound to observe the changes of appendix morphology, size and structure of the wall has an important value in the diagnosis and classification of acute appendicitis.