CAJ | 학술논문

目的：探讨在未使用胃肠道对比剂的情况下螺旋CT平扫对症状不典型阑尾炎的诊断价值。方法回顾性分析32例临床首诊未考虑是阑尾炎，而经手术病理证实为不典型阑尾炎病例的CT平扫及多平面重建图像表现，重点观察阑尾的位置、直径、阑尾壁的厚度、内容物及阑尾周围结构的改变。结果图像准确显示所有病例的阑尾在腹腔内的位置；其中可见阑尾增粗28例，阑尾结石9例，阑尾壁增厚8例，阑尾脓肿2例，阑尾周围炎24例，盆腔积液1例，伴有小肠梗阻6例。结论在不采用胃肠道对比剂的情况下，螺旋CT平扫联合平面重建技术可显示不典型阑尾炎的阑尾本身及其周边组织的病理改变情况，对诊断不典型阑尾炎具有重要价值。
목적：탐토재미사용위장도대비제적정황하라선CT평소대증상불전형란미염적진단개치。방법회고성분석32례림상수진미고필시란미염，이경수술병리증실위불전형란미염병례적CT평소급다평면중건도상표현，중점관찰란미적위치、직경、란미벽적후도、내용물급란미주위결구적개변。결과도상준학현시소유병례적란미재복강내적위치；기중가견란미증조28례，란미결석9례，란미벽증후8례，란미농종2례，란미주위염24례，분강적액1례，반유소장경조6례。결론재불채용위장도대비제적정황하，라선CT평소연합평면중건기술가현시불전형란미염적란미본신급기주변조직적병리개변정황，대진단불전형란미염구유중요개치。
Objective To investigate the diagnostic value of non-enhanced spiral CT scan without the gastro-intestinal contrast agents in appendicitis with atypically clinical manifestation. Methods CT scan and reconstruc-tion images of 32 cases of appendicitis which were not initially considered on ifrst clinical diagnostic conifrmed surgically and pathologically were retrospectively analyzed. The study appearance includes the location, diameter, wall thickness, content of appendix and structure around the appendix. Results CT images accurately show the location of the appendix in abdomen, and ifnd thickening appendix 28 cases, appendix stones 9 cases, thickening appendix wall 8 cases, appendix abscess 2 cases, inlfammation around appendix 24 cases, small bowel obstruction 6 cases, pelvic abscess 1 case. Conclusion Non-enhanced spiral CT scan combined with MPR technique without the gastrointestinal contrast agents can detect appendicitis appendix itself and the surrounding tissue pathological changes, so it has important diagnostic value for atypical appendicitis.