目的:比较超声和CT在小儿急慢性阑尾炎诊断中的应用价值。方法:回顾性分析我院经术后病理证实为阑尾炎的5~12岁小儿患者134例,与术前CT及超声结果进行对比,分别计算超声与CT诊断小儿急、慢性阑尾炎的灵敏度,比较两组的灵敏度差异;进一步计算急性阑尾炎中单纯与非单纯性阑尾炎的灵敏度,并进行统计学分析。结果:在5~12岁小儿急性阑尾炎影像诊断中,CT诊断价值优于超声;而诊断灵敏度差异主要体现在诊断急性单纯性阑尾炎时,两种检查方法在诊断非单纯性阑尾炎及慢性阑尾炎时没有明显统计学差异。结论:由于临床诊断小儿急慢性阑尾炎依赖影像学辅助检查,而CT扫描增加小儿恶性肿瘤的罹患率,因此可将超声作为诊断小儿急慢性阑尾炎的首选检查;当超声检查结果可疑或提示阴性而临床体征进行性加重时,建议再行CT检查。
Objective: To compare the diagnostic value of uhrasonography (US) with CT for pediatric acute and chronic appendicitis. Methods: Clinical data for 134 patients pathologically verified appendicitis at the age of 5 to 12 years old were retrospectively analyzed to compare the value of preoperative CT (n=134) and US (n=134) in the diagnosis and antidiastole of this disease from January 2013 to March 2014. The sensitivity of the two modalities was compared in the diagnosis of acute appendicitis and chronic appendicitis, acute simple appendicitis and acute non-simple appendicitis. Results: The diagnostic value of CT for acute appendicitis was significantly better than that of US. The sensitivity of US vs. CT were 69.75% vs. 81.51% in diagnosing acute appendicitis, respectively. Higher sensitivity was shown by CT in diagnosing acute simple appen- dicitis compared with US (84.38% vs. 62.50%, respectively; P〈0.05) while no difference was found in diagnosing acute non- simple appendicitis(g7.36% vs. 82.76% respectively, P〉O.05) or chronic appendicitis(66.67% vs. 40.00% respectively, P〉0.05). Conclusions: Uhrasonography can be considered as the first choice for the diagnosis of pediatric acute or chronic appendicitis. When US revealed negative or equivocal results with progressively aggravated symptoms, a CT scan was then needed.