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回盲动脉和静脉直径对急性阑尾炎的诊断准确性。

Diagnostic Accuracy of Ileocolic Artery and Vein Diameter for Acute Appendicitis.

机构信息

Department of General Surgery, Erol Olcok Training and Research Hospital, Hitit University, Çorum, Turkey.

出版信息

Med Sci Monit. 2024 Mar 1;30:e943846. doi: 10.12659/MSM.943846.

Abstract

BACKGROUND Regional inflammation-induced local vasodilation may exist in cases of appendicitis. In this study, the diameters of the ileocolic artery (ICA) and ileocolic vein (ICV) were measured using contrast-enhanced abdominal computed tomography (CT) scans in acute appendicitis cases. The study aimed to measure the diagnostic value of these measurements in the diagnosis of acute appendicitis. MATERIAL AND METHODS A total of 508 patients, including those with a diagnosis of acute appendicitis and a control group without appendicitis, were systematically evaluated. In all cases, the appendix was analyzed simultaneously on axial and coronal CT sections, and all measurement procedures were conducted with an electronic ruler after the actual images were magnified. Measurements of the ICA and ICV diameters were taken from the proximal 2-cm segments of the superior mesenteric artery and superior mesenteric vein in the axial plane. Demographic information, sex distribution, and ICA and ICV diameters were collected. RESULTS Of the 508 patients, 53.74% were men, and 46.26% were women. ICA and ICV diameters were significantly increased in the appendicitis group (P<0.001). Binomial logistic regression confirmed the independent predictive value of ICA and ICV diameters. Receiver operating characteristic curve analysis determined optimal cut-off values for distinguishing between the non-appendicitis and appendicitis groups (ICA: 2.475 mm, ICV: 3.885 mm) with high sensitivity and specificity. CONCLUSIONS ICA and ICV diameter measurements, in conjunction with major radiological findings, can enhance diagnostic accuracy in acute appendicitis cases. The use of ICA and ICV diameter measurements in diagnosing acute appendicitis offers a novel perspective in clinical practice.

摘要

背景

阑尾炎可能存在区域性炎症诱导的局部血管扩张。在这项研究中,通过对比增强腹部 CT 扫描测量了回结肠动脉(ICA)和回结肠静脉(ICV)的直径。该研究旨在测量这些测量值在急性阑尾炎诊断中的诊断价值。

材料和方法

系统评估了 508 例患者,包括诊断为急性阑尾炎的患者和无阑尾炎的对照组。在所有病例中,同时在轴位和冠状位 CT 切片上分析阑尾,并在实际图像放大后使用电子标尺进行所有测量程序。在轴位平面上,从肠系膜上动脉和肠系膜上静脉的近端 2cm 段测量 ICA 和 ICV 直径。收集人口统计学信息、性别分布以及 ICA 和 ICV 直径。

结果

508 例患者中,男性占 53.74%,女性占 46.26%。阑尾炎组的 ICA 和 ICV 直径明显增加(P<0.001)。二项逻辑回归证实了 ICA 和 ICV 直径的独立预测价值。接受者操作特征曲线分析确定了区分非阑尾炎和阑尾炎组的最佳截断值(ICA:2.475mm,ICV:3.885mm),具有较高的灵敏度和特异性。

结论

ICA 和 ICV 直径测量值结合主要影像学发现可提高急性阑尾炎的诊断准确性。在诊断急性阑尾炎时使用 ICA 和 ICV 直径测量值为临床实践提供了新的视角。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cde/10913285/18bbcc361843/medscimonit-30-e943846-g001.jpg

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Diagnosis of Uncomplicated and Complicated Appendicitis in Adults.成人单纯性和复杂性阑尾炎的诊断。
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