Karul M, Berliner C, Keller S, Tsui T Y, Yamamura J
Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Hamburg.
Department of General, Visceral- and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg.
Rofo. 2014 Jun;186(6):551-8. doi: 10.1055/s-0034-1366074. Epub 2014 Apr 23.
Three imaging modalities are available for the diagnosis of acute appendicitis: ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). Transabdominal ultrasound should be the first-line imaging test. Abdominal CT is superior to US and is required immediately in patients with atypical clinical presentation of appendicitis and suspected perforation. However, low-dose unenhanced CT is equal to standard-dose CT with intravenous contrast agents in the detection of five signs of acute appendicitis (thickened appendiceal wall more than 2 mm, cross-sectional diameter greater than 6 mm, periappendicitis, abscess, and appendicolith). MRI is necessary in pregnant women and young adults. This review illustrates the principles of state-of-the-art imaging techniques and their clinical relevance.
• US is the basic diagnostic method in case of suspected appendicitis.• CT is necessary in patients with atypical presentation of appendicitis.• MRI should be the first-line imaging test in pregnant women.
有三种成像方式可用于诊断急性阑尾炎：超声（US）、计算机断层扫描（CT）和磁共振成像（MRI）。经腹超声应作为一线成像检查。腹部CT优于超声，对于临床表现不典型的阑尾炎患者以及疑似穿孔的患者，应立即进行腹部CT检查。然而，低剂量非增强CT在检测急性阑尾炎的五个征象（阑尾壁增厚超过2毫米、横截面积直径大于6毫米、阑尾周围炎、脓肿和阑尾结石）方面与使用静脉造影剂的标准剂量CT相当。对于孕妇和年轻成年人，MRI是必要的。本综述阐述了先进成像技术的原理及其临床相关性。
• 对于疑似阑尾炎患者，超声是基本诊断方法。• 对于临床表现不典型的阑尾炎患者，CT是必要的。• 对于孕妇，MRI应作为一线成像检查。
