MSCT平扫在基层医院诊断儿童不典型急性阑尾炎的价值

王少华; 史建英; 杨志刚; 杨小刚; 王晓东

doi:10.13201/j.issn.1009-5918.2021.11.013

MSCT平扫在基层医院诊断儿童不典型急性阑尾炎的价值

- 长治市妇幼保健院医学影像科(山西长治, 046000)

详细信息

通讯作者: 史建英,E-mail:1207181107@qq.com

中图分类号: R656.8

收稿日期: 2021-05-09

The value of MSCT plain scan in the diagnosis of atypical acute appendicitis in children in primary hospitals

- Department of Medical Imaging, Changzhi Maternal and Child Health Hospital, Changzhi, Shanxi, 046000, China

More Information

Corresponding author: SHI Jianying, E-mail: 1207181107@qq.com

Received Date: 09 May 2021

摘要

摘要: 目的:探讨多层螺旋CT(MSCT)平扫诊断儿童不典型急性阑尾炎的价值。方法:回顾性收集20例临床表现不典型的儿童急性阑尾炎患儿MSCT影像学资料,并与术中、病理资料进行对照。结果:20例急性阑尾炎患儿均为不典型临床表现,术前MSCT影像:20例患儿均可见阑尾增粗、阑尾壁增厚,其中14例阑尾周围脂肪间隙模糊,12例阑尾内可见积液,6例阑尾穿孔合并周围脓肿形成,10例出现阑尾内粪石。影像资料与临床手术、病理资料进行对照结果一致。结论:MSCT平扫对儿童不典型急性阑尾炎定位及定性诊断有重要临床价值,并可评估其并发症,有利于临床早期制定科学合理治疗方案。
- 儿童 /
- 阑尾炎 /
- 体层摄影术 /
- X线计算机
Abstract: Objective:To explore the value of MSCT in the diagnosis of atypical acute appendicitis in children.Methods:The MSCT imaging data of 20 children with atypical clinical manifestations of acute appendicitis were collected retrospectively and compared with the interpretative and pathological data.Results:All the 20 children with acute appendicitis had atypical clinical manifestations. MSCT images before surgery:20 cases showed thickening of the appendix and thickening of the wall of the appendix. Among them, 14 cases had obscured fat space around the appendix, and 12 cases showed accumulation in the appendix. Liquid, 6 cases of appendix perforation combined with peripheral abscess formation, 10 cases of fecal stones in the appendix. The imaging data was consistent with the clinical operation and pathological data.Conclusion:MSCT plain scan has important clinical value for the localization and qualitative diagnosis of atypical acute appendicitis in children, and can evaluate its complications, which is beneficial to formulating scientific and reasonable treatment plans in the early clinical stage.
- children /
- appendicitis /
- tomography /
- X-ray computed

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参考文献(21)

[1]	张博诚,王连臣.成人复杂性阑尾炎临床预测评分模型的建立与验证[J].临床急诊杂志,2020,21(8):608-614.
[2]	Song CW,Kang JW,Kim JY.Different Clinical Features and Lower Scores in Clinical Scoring Systems for Appendicitis in Preschool Children:Comparison with School Age Onset[J].Pediatr Gastroenterol Hepatol Nutr,2018,21(1):51-58.
[3]	吴伟君,朱志强,梁均,等.超声与多层螺旋CT对可疑急性阑尾炎患者的诊断价值探讨[J].临床急诊杂志,2016,17(2):149-151.
[4]	姚秀芬,赵妮,延艳娜.高频超声联合临床Alvarado评分在降低阑尾炎误漏诊率中的价值[J].临床急诊杂志,2017,18(1):51-54.
[5]	顾秀婷,王苇,尹笑笑,等.小儿急性阑尾炎多层螺旋CT分级与病理表现比较研究[J].临床放射学杂志,2018,37(1):118-121.
[6]	蒋海燕,许云峰,胡慧勇,等.超声及CT检查对小儿急性阑尾炎的诊断价值[J].中国临床医学,2013,20(2):199-201.
[7]	王玉,贾立群,王晓曼,等.中国小儿阑尾外径正常值[J].中国介入影像与治疗学,2014,11(5):290-293.
[8]	蔡维波,周令飞,王磊,等.阑尾粪石征在急性阑尾炎CT诊断中的价值[J].临床和实验医学杂志,2011,10(19):1518-1520.
[9]	蒋昌和,苏珊娜.阑尾粪石征在超声诊断急性阑尾炎中的价值探讨[J].河北医科大学学报,2015,36(6):736-738.
[10]	陈海荣,袁立新,赵永江.MSCT诊断异位急性阑尾炎的临床价值分析[J].医学影像学杂志,2017,27(5):858-860,864.
[11]	朱洪基,余建群,彭礼清.小儿急性阑尾炎的双源CT评价[J].中国普外基础与临床杂志,2015,22(7):875-878.
[12]	刘文,强金伟,荆丽萨,等.多层螺旋CT诊断早期急性阑尾炎的价值[J].中华放射学杂志,2012,46(9):807-811.
[13]	贺国华,孙静,肖良平,等.超声联合CT对小儿不典型急性阑尾炎的诊断价值[J].临床超声医学杂志,2014,16(8):563-564.
[14]	Bax T,Macha M,Mayberry J.The utility of CT scan for the diagnostic evaluation of acute abdominal pain[J].Am J Surg,2019,217(5):959-966.
[15]	孙志南,黄益平,胡东来,等.儿童阑尾炎流行病学分析[J].中国乡村医药,2015,22(23):19.
[16]	李耀强.多排CT在急性阑尾炎穿孔与非穿孔中的鉴别诊断价值[J].临床急诊杂志,2016,17(5):393-395,398.
[17]	刘建新,陈勇,赵珊珊,等.超声鉴别儿童穿孔与非穿孔性阑尾炎[J].中国医学影像技术,2014,30(7):1050-1053.
[18]	黄益平,孙志南,郭晓东,等.5岁内小儿急性阑尾炎45例误诊原因分析[J].中国小儿急救医学,2014,21(7):448-450.
[19]	李晓燕,张海兵,金彪,王岩,李君,刘长林,蔡建荣.64层螺旋CT曲面重建及多平面重建技术对急性阑尾炎的诊断价值[J].临床急诊杂志,2014,15(8):462-464.
[20]	马宁,崔艳.MSCT三维重建技术对急性阑尾炎的临床诊断价值[J].临床急诊杂志,2015,16(3):170-171.
[21]	Alter SM,Walsh B,Lenehan PJ,et al.Radiology report "disclaimers" increase the use of abdominal CT in the work-up of pediatric abdominal pain[J].Am J Emerg Med,2018,36(4):556-559.