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目的探讨64排螺旋CT扫描在不典型急性阑尾炎诊断中的应用效果。方法 40例不典型急性阑尾炎患者作为研究对象,均因急腹症入院,经超声和64排螺旋CT检查后行手术治疗,术后病理检查确诊为急性阑尾炎,计算超声诊断、CT诊断与手术病理诊断结果符合率,并总结CT扫描影像学特征。结果 64排螺旋CT诊断显示,确诊为急性阑尾炎38例,误诊为回盲部肿块1例,误诊为右卵巢实性肿物1例,符合率为95.00%(38/40);超声诊断显示,确诊为急性阑尾炎33例,误诊为回盲部肿块4例,误诊为右卵巢实性肿物2例,1例单纯性阑尾增粗漏诊,符合率为82.50%(33/40);64排螺旋CT诊断符合率显著高于超声诊断,差异有统计学意义(P<0.05)。不典型急性阑尾炎64排螺旋CT扫描影像学特征为阑尾增粗、阑尾壁增厚、阑尾周边脂肪间隙炎性变化和周边器官异常变化等。结论不典型急性阑尾炎诊断采用64排螺旋CT扫描诊断准确性较高,可有效降低漏诊和误诊风险,临床诊断价值较好,值得推广使用。
Objective To investigate the application of 64-slice spiral CT in the diagnosis of atypical acute appendicitis. Methods Forty patients with atypical acute appendicitis were enrolled in this study. All of them were admitted to hospital due to acute abdomen disease. Surgical treatment was performed by ultrasound and 64-slice spiral CT. Acute appendicitis was diagnosed by postoperative pathology. Computed ultrasound, computed tomography (CT) and surgical pathology Diagnostic results coincide rate, and summarize CT scan imaging features. Results 64-slice spiral CT diagnosis showed that 38 cases were diagnosed as acute appendicitis, 1 case was misdiagnosed as ileocecal mass, 1 case was misdiagnosed as right ovarian solid mass, the coincidence rate was 95.00% (38/40) 33 cases were diagnosed as acute appendicitis, 4 cases were misdiagnosed as ileocecal masses, 2 cases were misdiagnosed as solid tumors of the right ovary, 1 case of simple appendix augmentation was missed, the coincidence rate was 82.50% (33/40) The coincidence rate of CT diagnosis was significantly higher than that of ultrasound diagnosis, the difference was statistically significant (P <0.05). Atypical acute appendicitis 64-slice spiral CT scan imaging features such as appendiceal thickening, thickening of the appendix wall, appendiceal fat gap inflammatory changes and peripheral organ abnormalities. Conclusion The diagnosis of atypical acute appendicitis with 64-slice spiral CT scan has higher diagnostic accuracy, which can effectively reduce the risk of missed diagnosis and misdiagnosis. The clinical diagnosis value is good and worthy of promotion.