多层螺旋CT在诊断小儿急性阑尾炎中的应用

目的:探讨多层螺旋CT对小儿急性阑尾炎的诊断价值。方法:回顾分析经临床手术病理证实的53例小儿急性阑尾炎的CT表现特点。所有患儿均行多排CT横断面扫描及MPVR重建。结果:53例中,单纯性阑尾炎2例;急性化脓性阑尾炎伴周围炎4例,其中1例合并紫癜;急性化脓性阑尾炎伴穿孔33例,其中1例合并回肠末端美克尔憩室;坏疽性阑尾炎伴穿孔6例;阑尾脓肿8例。CT平扫以及MPVR重建显示阑尾肿大、增粗(直径大于6mm)30例,阑尾内粪石27例,阑尾周围蜂窝织炎23例,阑尾周围脓肿8例,大量腹水6例。结论:多层螺旋CT扫描及重建技术能为小儿阑尾炎的诊断提供有力依据,提高临床术前诊断能力。

Application of Multi-slice Spiral CT in the Diagnosis of Infant Acute Appendicitis

Objective:To investigate the application of multi-slice spiral CT in the diagnosis of infant acute appendicitis.Methods: 53 infants with pathologically confirmed acute appendicitis were studied.Regular axial images were scanned by multi-slice spiral CT, and multi planner volume reconstruction (MPVR) was then performed.Clinical information and CT data were retrospectively analyzed. Results:Among 53 patients,2 had acute simple appendicitis;4 had acute suppurative appendicitis with periappendicitis,including l child with peliosis complication;33 had acute suppurative appendicitis associated with perforation,including l child with Michael's diverticu- lum;6 had appendices gangrene accompanying with perforation;and 8 had appendiccal abscess.It showed that there ware 30 cases with enlarged appendix with the diameter greater than 6mm,27 cases with appcndiceal fecalithes,23 cases with periappendiceal inflamma- tion,8 cases with appendiceal abscess,and 6 cases with large amount of ascitic on CT image and MPVR reconstruction.Conclusions: Multi-slice spiral CT scan and MPVR reconstruction provide valuable information to diagnose infant acute appendicitis,and to make pre- operative evaluation.