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超声联合CT在早期低度阑尾黏液性肿瘤与阑尾炎鉴别诊断中的价值

The value of ultrasound combined with CT in identifying early low-grade appendiceal mucinous neoplasm and appendicitis.

作者信息

Bai Dong, Zhou Nan, Dou Ruixue, Wang Jiajun, Zhang Pu, Wang Haoyu, Wang Zhiqun, Liang Lei

机构信息

Department of Radiology, Aerospace Center Hospital, Beijing, China.

Department of Ultrasound, Aerospace Center Hospital, Beijing, China.

出版信息

Front Oncol. 2023 Oct 2;13:1191785. doi: 10.3389/fonc.2023.1191785. eCollection 2023.

Abstract

OBJECTIVE

The aim of this study is to investigate the value of ultrasound combined with computed tomography (CT) in identifying early low-grade appendiceal mucinous neoplasm and appendicitis.

METHODS

Patients with early low-grade appendiceal mucinous neoplasm and appendicitis from September 2017 to September 2021, including 40 patients with low-grade appendiceal mucinous neoplasm and 40 patients with appendicitis, were collected in this study. Clinical data as well as ultrasound and CT findings of all patients were retrospectively analyzed. Univariate and multivariate logistic regression analyses were applied to establish the ultrasound model, the CT model, and the combined model.

RESULTS

The nomogram showed that specific characteristics of CT were dilated appendiceal diameter and clear surrounding fat space in the low-grade appendiceal mucinous neoplasm and that specific characteristics of ultrasound were thin or clear layer appendix wall and flocculent echo in the appendix cavity. These four features were used to construct a nomogram for predicting early low-grade appendiceal mucinous neoplasm, and the area under the curve value was 0.839.

CONCLUSION

Ultrasound combined with CT for diagnosis of early low-grade appendiceal mucinous neoplasm has a significant value; when found significantly dilated appendix in the lower right abdomen, with thin wall, wall calcification, clear surrounding fat space, and progressive enhancement, especially non-specific symptoms similar to appendicitis, the physician should timely consider the possibility of low-grade appendiceal mucinous neoplasm.

摘要

目的

本研究旨在探讨超声联合计算机断层扫描(CT)在鉴别早期低度阑尾黏液性肿瘤和阑尾炎中的价值。

方法

本研究收集了2017年9月至2021年9月期间患有早期低度阑尾黏液性肿瘤和阑尾炎的患者,包括40例低度阑尾黏液性肿瘤患者和40例阑尾炎患者。对所有患者的临床资料以及超声和CT检查结果进行回顾性分析。采用单因素和多因素逻辑回归分析建立超声模型、CT模型和联合模型。

结果

列线图显示,CT的特征性表现为低度阑尾黏液性肿瘤中阑尾直径增宽和周围脂肪间隙清晰,而超声的特征性表现为阑尾壁薄或清晰以及阑尾腔内絮状回声。利用这四个特征构建了预测早期低度阑尾黏液性肿瘤的列线图,曲线下面积值为0.839。

结论

超声联合CT诊断早期低度阑尾黏液性肿瘤具有重要价值;当在右下腹发现阑尾明显增宽,壁薄、壁钙化,周围脂肪间隙清晰,且呈渐进性强化,尤其是伴有类似阑尾炎的非特异性症状时,医生应及时考虑低度阑尾黏液性肿瘤的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/02b1/10578960/9d7890d1097f/fonc-13-1191785-g001.jpg

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