Rao P M, Rhea J T, Novelline R A
Department of Radiology, Massachusetts General Hospital, Boston 02114, USA.
Clin Radiol. 1997 Oct;52(10):750-4. doi: 10.1016/s0009-9260(97)80153-5.
Appendiceal air has been reported as both a sign of appendicitis and of a normal appendix both at plain radiography and computed tomography (CT). It is the aim of this investigation to determine the prevalence, range of appearances, and significance of appendiceal and peri-appendiceal air at CT.
Appendiceal CT scans of 100 patients with proven appendicitis and 100 patients with a normal appendix were reviewed for the presence of appendiceal and peri-appendiceal air. All cases were correlated with surgical and pathological findings or clinical follow-up.
In 100 CT cases of appendicitis, appendiceal and/or peri-appendiceal air was present in one or more forms in 31% of cases. When present, it appeared as intraluminal air bubbles (38.7%) or air-fluid levels (22.6%), appendolith air (41.9%), intramural air (16.1%), peri-appendiceal air bubbles (12.9%), or extraluminal air-fluid level(s) (29.0%). Intramural and extraluminal air correlated with perforation in 60% and 100%, respectively. In 100 CT cases of a normal appendix, air was present in 57%. It was always intraluminal and appeared as small bubbles of air (52.6%), a tubular-shaped air collection (43.9%), or as an air-fluid level (3.5%). The appendiceal lumen was either airless (43%), or minimally (32%), moderately (18%), or completely filled with air (7%).
Air is a common finding at appendiceal CT in both the normal and inflamed appendix. Intraluminal air is seen in both appendicitis and normal appendices, and cannot be presumed to indicate a patent lumen and thus a normal appendix. Appendolith, intramural and peri-appendiceal air appear diagnostic of appendicitis.
在平片和计算机断层扫描（CT）中，阑尾积气既被报道为阑尾炎的征象，也被报道为正常阑尾的表现。本研究的目的是确定CT上阑尾及阑尾周围积气的发生率、表现形式及意义。
回顾100例经证实的阑尾炎患者和100例正常阑尾患者的阑尾CT扫描，以观察阑尾及阑尾周围积气情况。所有病例均与手术及病理结果或临床随访情况相关。
在100例阑尾炎CT病例中，31%的病例存在阑尾及/或阑尾周围积气，且以一种或多种形式出现。出现时，表现为腔内气泡（38.7%）或气液平面（22.6%）、阑尾结石积气（41.9%）、壁内积气（16.1%）、阑尾周围气泡（12.9%）或腔外气液平面（29.0%）。壁内积气和腔外积气分别与60%和100%的穿孔相关。在100例正常阑尾CT病例中，57%存在积气。积气总是在腔内，表现为小气泡（52.6%）、管状气体聚集（43.9%）或气液平面（3.5%）。阑尾腔要么无气（43%），要么少量充气（32%）、中度充气（18%）或完全充气（7%）。
在正常阑尾和发炎阑尾的CT检查中，积气都是常见表现。阑尾炎和正常阑尾中均可看到腔内积气，不能据此推断管腔通畅从而认为阑尾正常。阑尾结石、壁内及阑尾周围积气似乎可诊断阑尾炎。
