MRI在急性单纯性阑尾炎中的诊断价值

发布时间：2018-01-24 19:05

本文关键词： 磁共振成像扩散加权成像急性单纯性阑尾炎　出处：《中国医学计算机成像杂志》2017年01期 　论文类型：期刊论文

【摘要】：目的:探讨MRI在急性单纯性阑尾炎中的诊断价值。方法:16只经手术和病理证实为急性单纯性阑尾炎及18只经手术和病理证实为正常阑尾的新西兰大白兔先后进行MSCT和MRI检查。在MSCT及MRI图像上分别测量阑尾腔内液体的最大直径(MDIAF)。以b值为800 s/mm~2的扩散加权成像(DWI)图像上阑尾壁信号最高的部位为参考,在ADC图像上相应的感兴趣区(ROI)部位测量ADC值。绘制MDIAF、阑尾壁ADC值诊断急性单纯性阑尾炎的ROC曲线,计算敏感度、特异度、准确度和曲线下面积。MSCT与MRI采用MDIAF诊断急性单纯性阑尾炎ROC曲线下面积的比较采用卡方检验。结果:MSCT采用MDIAF诊断急性单纯性阑尾炎的敏感度、特异度、准确度分别为87.50%(14/16)、83.33%(15/18)、85.29%(29/34),ROC曲线下面积为0.85。MRI采用MDIAF诊断急性单纯性阑尾炎的敏感度、特异度、准确度分别为87.50%(14/16)、77.78%(14/18)、82.35%(28/34),ROC曲线下面积为0.87。MSCT与MRI采用MDIAF诊断急性单纯性阑尾炎ROC曲线下面积的比较无统计学差异(χ2=0.17,P=0.68)。当阑尾壁ADC值为0.97×10-3mm~2/s时,诊断急性单纯性阑尾炎的敏感度、特异度、准确度分别为81.25%(13/16)、83.33%(15/18)、82.35%(28/34),ROC曲线下面积为0.84。结论:MRI在诊断急性单纯性阑尾炎方面具有较高的诊断价值,可以广泛用于腹痛疾病的鉴别诊断,尤其是孕妇及儿童群体。
[Abstract]:Objective: to evaluate the diagnostic value of MRI in acute simple appendicitis. MSCT and MRI examinations were performed on 16 New Zealand rabbits with acute appendicitis confirmed by operation and pathology and 18 New Zealand rabbits with normal appendicitis confirmed by operation and pathology. MSCT and MRI images were performed on the images. The maximum diameter of the fluid in the appendiceal cavity was measured. The position of the highest signal of appendix wall on DWI image with b value of 800 s / mm ~ (-2) was taken as reference. The ADC value was measured in the corresponding region of interest (ROI) on ADC image. The ROC curve of ADC value of appendix wall was drawn to diagnose acute simple appendicitis, and the sensitivity and specificity were calculated. Accuracy and area under curve. MSCT was compared with MRI in the diagnosis of acute simple appendicitis under ROC curve by MDIAF. Results:. MSCT used MDIAF to diagnose acute simple appendicitis. The specificity and accuracy were 87.50%, 83.33% and 85.29%, respectively. The area under the ROC curve was 0.85.The sensitivity, specificity and accuracy of MDIAF in the diagnosis of acute simple appendicitis were 87.50 / 14 / 16 respectively. 77.78 / 18 / 82.35 / (28 / 34). The area under ROC curve was 0.87.MSCT and MRI was used to diagnose acute simple appendicitis by MDIAF. There was no significant difference in the area under ROC curve (蠂 2 = 0.17). The sensitivity and specificity of acute simple appendicitis were detected when the ADC value of appendicitis was 0.97 脳 10 ~ (-3) mm / s. The accuracy was 81.25 / 83.33 / 82.35 / 82.35, respectively (28 / 34). The area under the ROC curve is 0.84.Conclusion the ROC has a high diagnostic value in the diagnosis of acute simple appendicitis, and can be widely used in the differential diagnosis of abdominal pain diseases, especially in pregnant women and children.
【作者单位】：复旦大学附属金山医院放射科;复旦大学附属金山医院病理科;
【基金】：上海市金山区科委基金资助项目(编号:2015-3-1)~~
【分类号】：R656.8;R445.2
【正文快照】： 急性阑尾炎(acute appendicitis,AA)是常见的急腹症之一,人群患病率高达6%~12%[1-3]。典型者通过临床表现和实验室检查可明确诊断,但约有30%的患者症状不典型[4-5],而且部分其他疾病的临床表现酷似AA[6-7],仅基于临床表现和实验室检查诊断AA时,剖腹探查的阴性率为16%~47%,而延

【相似文献】