Borushok K F, Jeffrey R B, Laing F C, Townsend R R
Department of Radiology, University of California, San Francisco General Hospital 94110.
AJR Am J Roentgenol. 1990 Feb;154(2):275-8. doi: 10.2214/ajr.154.2.2105013.
The sonographic diagnosis of appendicitis can be challenging in patients with perforation. In order to detect the accuracy of specific sonographic features of appendiceal perforation, graded compression sonograms in 100 patients with surgically confirmed acute appendicitis were reviewed retrospectively. Twenty-two of these patients had perforation. A statistically significant association was found between three sonographic findings and perforation: loculated pericecal fluid, prominent pericecal fat, and circumferential loss of the submucosal layer of the appendix. No single finding had a specificity greater than 59%. By using a combination of one or more findings, the overall sensitivity of sonography for the diagnosis of perforation was 86%. The specificity, however, was only 60%. Our results suggest that in patients without a sonographically visible appendix, recognition of loculated pericecal fluid and prominent pericecal fat may be a useful indirect clue to the diagnosis of perforating appendicitis.
对于穿孔性阑尾炎患者，超声诊断可能具有挑战性。为了检测阑尾穿孔特定超声特征的准确性，我们回顾性分析了100例经手术证实为急性阑尾炎患者的分级加压超声图像。其中22例患者发生了穿孔。我们发现三个超声表现与穿孔之间存在统计学上的显著关联：局限性盲肠周围积液、显著的盲肠周围脂肪以及阑尾黏膜下层的环形缺失。没有单一表现的特异性大于59%。通过使用一个或多个表现的组合，超声诊断穿孔的总体敏感性为86%。然而，特异性仅为60%。我们的结果表明，在超声检查看不到阑尾的患者中，识别局限性盲肠周围积液和显著的盲肠周围脂肪可能是诊断穿孔性阑尾炎的有用间接线索。
