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计算机断层扫描和超声检查在急性阑尾炎中的诊断价值。

The diagnostic value of the computed tomography scan and ultrasonography in acute appendicitis.

作者信息

Bahrami Mahshid, Mirgaloyebayat Hannaneh, Mohajeri Zahra, Mohammadi Hossein, Afshari Samira Amin, Fazeli Pooya, Masaeli Dorna, Nourian Sayed Mohammad Amin

机构信息

Assistant Professor, Department of Radiology, Isfahan University of Medical Sciences Isfahan, Iran.

Department of Radiology, Isfahan University of Medical Sciences Isfahan, Iran.

出版信息

Am J Nucl Med Mol Imaging. 2023 Feb 15;13(1):11-17. eCollection 2023.

Abstract

The most prevalent cause of emergency abdominal surgery is acute appendicitis. Ultrasonography is safe and widely available, although it's operator-dependent and difficult for people with massive bodies. Computed tomography (CT) scans are more accurate than ultrasonography, with a 93 to 98% accuracy rate. The goal of this investigation is to evaluate the diagnostic value of ultrasonography and CT scanning for acute appendicitis. This is a cross-sectional study that was performed on 231 patients with suspected with acute appendicitis. The Alvarado score was initially used to diagnose acute appendicitis. A radiologist performed abdominal ultrasonography on all patients. If the results of the ultrasonography were negative or unclear, a CT scan was performed using oral contrast. Finally, all ultrasonography and CT scan data were reevaluated by an experienced radiologist and compared to the patient's final diagnosis in the case of surgery and pathology results. Comparisons between the two groups were performed. The sensitivity, specificity, and positive and negative predictive value of ultrasonography according to pathology results in patients with low clinical suspicion were 74.9%, 63.4%, 94.3%, and 67.6%, respectively. The sensitivity, specificity, positive and negative predictive value of CT scans based on pathology results were 87.9%, 81.8%, 94.7%, and 79.3%, respectively, in patients with low clinical suspicion. The CT scan results in female patients suspected of appendicitis were completely consistent with the pathology results. The CT scan demonstrated greater specificity and sensitivity in diagnosing acute appendicitis compared to abdominal ultrasonography.

摘要

急诊腹部手术最常见的病因是急性阑尾炎。超声检查安全且应用广泛,不过它依赖操作者,对体型肥胖者检查困难。计算机断层扫描(CT)比超声检查更准确,准确率为93%至98%。本研究的目的是评估超声检查和CT扫描对急性阑尾炎的诊断价值。这是一项针对231例疑似急性阑尾炎患者的横断面研究。最初使用阿尔瓦拉多评分来诊断急性阑尾炎。一名放射科医生对所有患者进行腹部超声检查。如果超声检查结果为阴性或不明确,则使用口服造影剂进行CT扫描。最后,由一位经验丰富的放射科医生重新评估所有超声检查和CT扫描数据,并与手术和病理结果情况下患者的最终诊断进行比较。对两组进行了比较。临床怀疑度较低患者中,根据病理结果,超声检查的敏感性、特异性、阳性预测值和阴性预测值分别为74.9%、63.4%、94.3%和67.6%。临床怀疑度较低患者中,基于病理结果,CT扫描的敏感性、特异性、阳性预测值和阴性预测值分别为87.9%、81.8%、94.7%和79.3%。疑似阑尾炎女性患者的CT扫描结果与病理结果完全一致。与腹部超声检查相比,CT扫描在诊断急性阑尾炎方面具有更高的特异性和敏感性。

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