Application of Low Dosage MSCT Multiplanar Reconstruction in Preliminary Diagnosis of Acute Appendicitis in Children
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摘要: 目的：探讨应用多层螺旋CT（MSCT）低剂量扫描联合多平面重建技术在儿童急性阑尾炎早期诊断中的价值。方法：对45例经手术病理证实的儿童急性阑尾炎在早期行MSCT低剂量扫描，通过多平面重建技术总结其影像表现特点。结果：所检查患儿的CT有效辐射剂量（2.66±0.39）mSv；45例患儿中，急性单纯性22例；化脓性伴周围渗出15例，有4例穿孔；坏疽性5例，有3例穿孔；阑尾脓肿3例。MSCT多平面重建示阑尾肿大32例，阑尾腔内显示粪石25例，阑尾腔内积聚液体气体18例，阑尾周围出现脂肪条纹征11例，回盲部区域肠管管壁增厚28例，伴有肠管淤张30例，肿大淋巴结33例，腹膜增厚5例，阑尾周围脓肿3例，阑尾穿孔、腔外出现游离气体7例，腹盆腔积液12例。结论：在早期诊断儿童急性阑尾炎中，运用低剂量MSCT联合多平面重建技术不仅剂量低、辐射小，而且简便准确，减少漏诊和误诊率，可以指导外科医生制定最优的手术方案，有较高的应用价值，适宜推广使用。Abstract: Objective: We intend to evaluate the application of low dosage multi-spiral CT (MSCT) combined with multiplanar reconstruction in the preliminary diagnosis of acute appendicitis in children. Methods: We performed low dosage MSCT scanning on 45 cases of children with acute appendicitis confirmed by operation and pathology. The imaging features were manifested through multiplanar reconstruction technology. Results: The effective radiation dosage of CT was (2.66±0.39) mSv; among the 45 cases, 22 cases were acute simple appendicitis; 15 cases were purulent with peripheral exudation, 4 cases were perforated gastroenteritis; 5 cases were gangrenous gastroenteritis, 3 cases were perforated gastroenteritis; 3 cases were appendiceal abscess. MSCT multiplanar reconstruction showed 32 cases of appendiceal enlargement, 25 cases of fecal calculus, 18 cases of liquid gas accumulation, 11 cases of fat stripe around appendix, 28 cases of intestinal wall thickening in ileocecal region, 30 cases of intestinal congestion, 33 cases of enlarged lymph nodes, 5 cases of peritoneal thickening, 3 cases of appendiceal abscess, 7 cases of appendix perforation and extraluminal free gas, and 12 cases of abdominal and pelvic effusion. Conclusion: In the preliminary diagnosis of acute appendicitis in children, the application of low dosage MSCT combined with multiplanar reconstruction not only holds the advantage of smaller dose and lower radiation, but also proves to be simple and accurate with lower rate of missed diagnosis and misdiagnosis. This technology showed significant application value, we suggest that it can be promoted to be apllied in guiding surgeons to formulate optimal operation plan.
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Keywords:
- appendicitis /
- multi-spiral CT /
- multiplanar reconstruction
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