| 摘要: |
| 目的 分析临界外径范围内急性阑尾炎与正常阑尾声像图差异,探讨其对超声诊断儿童急性阑尾炎的意义。方法 于2019年1月~2023年5月我院疑诊急性阑尾炎并行超声检查的患儿中连续收集阑尾外径0.6cm~0.7cm的病例,并根据临床最终诊断结果分为确诊阑尾炎、排除阑尾炎组。比较两组病例声像图差异,找出在临界外径范围内有助于鉴别诊断急性阑尾炎与正常阑尾的声像图特征。结果 两组病例“阑尾周围系膜网膜增厚”、“阑尾腔内粪石”及“阑尾周围积液”的声像图差异比较具有统计学意义(p<0.05),其中“阑尾周围系膜网膜增厚”对于临界外径范围内急性阑尾炎与正常阑尾的鉴别诊断具有较高且稳定的诊断效能(AUC=0.906, 95% CI 0.855—0.957),敏感度为100%(95%CI 96.4S%—100%),特异度为81%(95%CI 71.9S%—88.2%)。结论 超声能有效应用于临界外径范围内急性阑尾炎与正常阑尾的鉴别诊断,其中“阑尾周围系膜网膜增厚”的声像图特征具有重要鉴别诊断价值。 |
| 关键词: 超声检查 儿童 阑尾炎 外径 |
| DOI： |
| 投稿时间：2023-08-24修订日期：2023-10-11 |
| 基金项目: |
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| Ultrasonic differential diagnosis of appendicitis and normal appendix within critical outer diameter |
| bi shi yue,wang yu,xiong xiao ling,jia li qun,wang xiao man |
| (Beijing Children′s Hospital, Capital Medical University, National center for children’s Health) |
| Abstract: |
| Objective To analyze the differences of ultrasonographic features between acute appendicitis and normal appendix within critical outer diameter, and to explore the significance of these ultrasonographic features in the diagnosis of acute appendicitis in children. Methods From January 2019 to May 2023, children suspected of acute appendicitis and received ultrasound examination in our hospital were continuously collected and divided into confirmed appendicitis group and excluded appendicitis group according to the final clinical diagnosis results. Compared the differences of ultrasonographic features between the two groups of cases, and found out the ultrasonographic features which were helpful to the differential diagnosis of acute appendicitis and normal appendix. Results There were significant differences between the two groups in the ultrasonographic features of periappendicular mesenteric and omental thickening, appendicular fecalith and periappendicular effusion (p<0.05). Periappendiceal mesenteric and omental thickening had good and stable diagnostic efficacy in the differential diagnosed between acute appendicitis and normal appendix within the critical outer diameter(AUC=0.906, 95% CI 0.855—0.957), the sensitivity was 100% (95%CI 96.4%—100%), and the specificity was 81% (95%CI 71.9%-88.2%). Conclusion Ultrasound could be used effectively in the differential diagnosis of acute appendicitis and normal appendix within the critical outer diameter, and the ultrasonographic features of periappendicular mesenteric and omental thickening had great value in differential diagnosis. |
| Key words: Ultrasonography Children Appendicitis Outer diameter |
