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目的探讨多层螺旋CT(multi-slice spiral CT,MSCT)多平面重建(multi-planar reconstruction,MPR)及曲面重建(curved planar reformation,CPR)诊断急性阑尾炎的价值。方法 88例拟诊急性阑尾炎患者,术前均行MSCT检查并进行MPR、CPR后处理,比较未重建及重建后CT征象显示率;与手术组织病理结果进行对照,比较未重建及重建图像诊断急性阑尾炎的灵敏度、特异度。结果重建图像阑尾外径增粗(90.91%)、阑尾管壁增厚(73.86%)、阑尾周围渗出改变(90.91%)、阑尾积液(39.77%)、阑尾结石(62.50%)、阑尾穿孔(28.41%)、回盲部肠壁增厚(88.63%)显示率及阑尾异常总显示率(98.86%)均高于未重建图像(68.18%、50.00%、73.86%、25.00%、44.32%、13.63%、73.86%、90.91%)(P<0.05);手术组织病理诊断急性阑尾炎82例,重建图像诊断急性阑尾炎的灵敏度(97.6%)和特异度(83.3%)均高于未重建图像(64.6%、50.0%)(P<0.05)。结论 MSCT扫描后进行MPR及CPR重建,可直观显示阑尾及其周围结构和病理变化,提高急性阑尾炎的诊断灵敏度和特异度。
Objective To investigate the value of multi-planar reconstruction (MPR) and curved planar reformation (CPR) in the diagnosis of acute appendicitis by multi-slice spiral CT (MSCT). Methods A total of 88 patients with acute appendicitis were enrolled in this study. MSCT was performed preoperatively and MPR and CPR post-treatment were performed. The CT signs of non-reconstructed and reconstructed CT angiography were compared with those of surgical histopathology. The reconstructed and reconstructed images were compared for diagnosis of acute Appendicitis sensitivity, specificity. Results The diameter of appendix enlarged (90.91%), thickening of appendix wall (73.86%), change of appendiceal effusion (90.91%), appendix effusion (39.77%), appendix calculus (62.50%), appendix perforation (28.41%), total ileocecal intestinal wall thickening (88.63%) and total appendix abnormality (98.86%) were significantly higher than those of non-reconstructed images (68.18%, 50.00%, 73.86%, 25.00%, 44.32% The sensitivity and specificity of the reconstructed images in the diagnosis of acute appendicitis were higher than those of the non-reconstructed images (64.6%, 63.63%, 73.86%, 90.91% respectively) (P <0.05) %, 50.0%) (P <0.05). Conclusion MPR and CPR reconstruction after MSCT scan can directly show the appendix and its surrounding structures and pathological changes, and improve the diagnostic sensitivity and specificity of acute appendicitis.