Wijetunga Raj, Doust Bruce, Bigg-Wither Grant
Department of Medical Imaging, St. Vincents Hospital, Victoria St. Darlinghurst, Sydney N.S.W. 2010, Australia.
Semin Ultrasound CT MR. 2003 Apr;24(2):101-6. doi: 10.1016/s0887-2171(03)90007-2.
In clinically equivocal cases of acute appendicitis, CT performed after the opacification of the terminal ileum and the cecum offers a significant improvement in diagnostic accuracy when compared to diagnosis based on clinical signs and symptoms alone. The method employed to opacify the bowel has been the subject of discussion in the literature. We believe that the oral administration of contrast, without the use of rectal or intravenous contrast, provides the best combination of diagnostic accuracy and convenience. The CT signs of acute appendicitis are described. Ways of minimizing the difficulties of diagnosing a ruptured appendix are discussed. Because of the radiation involved, CT should not be used routinely in acute appendicitis, but should be reserved for clinically equivocal cases.
在急性阑尾炎临床诊断不明确的病例中，与仅基于临床体征和症状进行诊断相比，在回肠末端和盲肠显影后进行CT检查可显著提高诊断准确性。使肠道显影所采用的方法一直是文献讨论的主题。我们认为，口服造影剂，不使用直肠或静脉造影剂，可提供诊断准确性和便利性的最佳组合。文中描述了急性阑尾炎的CT征象。讨论了将诊断阑尾破裂的困难降至最低的方法。由于涉及辐射，CT不应常规用于急性阑尾炎，而应保留用于临床诊断不明确的病例。
