Department of Radiology, Saitama Medical Center, Saitama Medical School, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan.
Jpn J Radiol. 2012 Apr;30(3):242-8. doi: 10.1007/s11604-011-0039-2. Epub 2011 Dec 22.
Appendiceal diverticulitis has been difficult to distinguish from acute appendicitis clinically and radiologically. The purpose of this study was to describe multidetector computed tomography (MDCT) features of cases of pathologically proved appendiceal diverticulitis at our institution over a 36-month period.
Seven of 156 patients who underwent appendectomy with the preoperative diagnosis of acute appendicitis were pathologically diagnosed with appendiceal diverticulitis. Two radiologists reviewed the MDCT images for these 7 patients.
On MDCT, a total of 8 inflamed diverticula were visualized as small fluid-filled luminal structures with thick enhanced walls or as solid enhanced masses protruding from the appendix for 6 of 7 patients. For 2 of these 6 patients, MDCT revealed a total of 5 normal diverticula visualized as small air-filled luminal structures with thin walls. For 1 of the 7 patients, neither inflamed or normal diverticula could be identified on MDCT. MDCT revealed appendiceal wall thickening with a tiny or no luminal fluid collection for 5 patients and with a moderate fluid collection for 1 patient, and a normal appendiceal wall for 1 patient.
Our results suggest that MDCT can reveal appendiceal diverticula and has potential in the preoperative diagnosis of appendiceal diverticulitis.
在临床上和放射学上，阑尾憩室炎一直难以与急性阑尾炎相区别。本研究的目的是描述在过去 36 个月中我院经病理证实的阑尾憩室炎病例的多排 CT（MDCT）特征。
在 156 例行阑尾切除术且术前诊断为急性阑尾炎的患者中，有 7 例被病理诊断为阑尾憩室炎。两名放射科医生对这 7 例患者的 MDCT 图像进行了回顾性分析。
在 MDCT 上，对于 7 例患者中的 6 例，共可见 8 个发炎的憩室，表现为小的充满液体的腔状结构，伴增厚的强化壁，或作为从阑尾突出的实性强化肿块。对于这 6 例患者中的 2 例，MDCT 还显示了总共 5 个正常的憩室，表现为小的充气腔状结构，壁薄。在 7 例患者中的 1 例，MDCT 无法识别发炎或正常的憩室。MDCT 显示阑尾壁增厚，5 例患者阑尾腔内有小或无液体积聚，1 例患者阑尾腔内有中等量液体积聚，1 例患者阑尾壁正常。
我们的结果表明，MDCT 可以显示阑尾憩室，并有可能在术前诊断阑尾憩室炎。
