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超声与多层螺旋计算机断层扫描在急性阑尾炎诊断价值的评估:一项回顾性研究

Assessment of diagnostic value of ultrasound and multi-slice spiral computed tomography in acute appendicitis: a retrospective study.

作者信息

Lu Kai, Zhong Furui, Miao Juan, Sun Chong, Zhou Kaibo, Wang Wei, Zhang Faqiang, Yang Hua, Lan Ke

机构信息

Department of General Surgery of Huidong, Zigong Fourth People's Hospital, Zigong, 643000, China.

Department of Ultrasonography, Zigong Fourth People's Hospital, Zigong, 643000, China.

出版信息

Abdom Radiol (NY). 2025 Mar;50(3):1117-1122. doi: 10.1007/s00261-024-04584-2. Epub 2024 Sep 19.

DOI:10.1007/s00261-024-04584-2
PMID:39294319
Abstract

PURPOSE

Ultrasound and multi-slice spiral computed tomography (CT) are frequently used to assist the diagnosis of acute appendicitis (AA), and the examination results may vary among different demographics. This study aimed to compare the diagnostic accuracy of ultrasound and CT for AA.

METHODS

We performed a retrospective analysis of patients diagnosed with AA who underwent emergency surgery at our hospital from March 2021 to August 2023, with postoperative pathological results as the gold standard. Differences in the diagnostic accuracy of ultrasound and CT for different types of AA, age groups, and body mass index (BMI) values were then analyzed.

RESULTS

The overall sample comprised 279 confirmed cases of AA, with 64 cases of simple appendicitis, 127 cases of suppurative appendicitis, and 88 cases of gangrenous appendicitis. For these three pathological classifications, the diagnostic accuracy of ultrasound was 68.75% (44/64), 73.22% (93/127), and 81.81% (72/88), respectively, while the diagnostic accuracy of CT was 71.87% (46/64), 82.67% (105/127), and 90.90% (80/88), respectively. There was no statistically significant difference in the overall diagnostic accuracy between the two methods (P > 0.05). Subgroup analysis showed no difference in diagnostic accuracy between the two methods for patients with normal BMI (P > 0.05). However, for overweight, obese, and elderly patients, CT provided significantly better diagnostic accuracy than ultrasound (P < 0.05).

CONCLUSION

While ultrasound and CT have similar diagnostic accuracy for different pathological types of AA, CT is more accurate for overweight, obese, and elderly patients.

摘要

目的

超声和多层螺旋计算机断层扫描(CT)常用于辅助急性阑尾炎(AA)的诊断,不同人群的检查结果可能存在差异。本研究旨在比较超声和CT对AA的诊断准确性。

方法

我们对2021年3月至2023年8月在我院接受急诊手术且诊断为AA的患者进行回顾性分析,以术后病理结果作为金标准。然后分析超声和CT对不同类型AA、年龄组和体重指数(BMI)值的诊断准确性差异。

结果

总体样本包括279例确诊的AA病例,其中单纯性阑尾炎64例,化脓性阑尾炎127例,坏疽性阑尾炎88例。对于这三种病理分类,超声的诊断准确性分别为68.75%(44/64)、73.22%(93/127)和81.81%(72/88),而CT的诊断准确性分别为71.87%(46/64)、82.67%(105/127)和90.90%(80/88)。两种方法的总体诊断准确性无统计学显著差异(P>0.05)。亚组分析显示,BMI正常的患者中两种方法的诊断准确性无差异(P>0.05)。然而,对于超重、肥胖和老年患者,CT的诊断准确性明显优于超声(P<0.05)。

结论

虽然超声和CT对不同病理类型的AA诊断准确性相似,但CT对超重、肥胖和老年患者更准确。

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本文引用的文献

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The Emergency Surgery Frailty Index (EmSFI) in Elderly Patients with Acute Appendicitis: An External Validation of Prognostic Score.老年急性阑尾炎患者的急诊手术虚弱指数(EmSFI):预后评分的外部验证。
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Am J Nucl Med Mol Imaging. 2023 Feb 15;13(1):11-17. eCollection 2023.
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Value of ultrasound and computed tomography in the diagnosis of acute appendicitis with histopathology as gold standard.
超声和计算机断层扫描在以组织病理学为金标准的急性阑尾炎诊断中的价值。
Acta Chir Belg. 2023 Dec;123(6):654-658. doi: 10.1080/00015458.2022.2136050. Epub 2022 Oct 25.
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World J Emerg Surg. 2020 Apr 15;15(1):27. doi: 10.1186/s13017-020-00306-3.
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