ABSTRACT
Objective@#To study and compare the diagnostic value of computed tomography(CT) with different doses in acute appendicitis.@*Methods@#A total of 90 suspected acute appendicitis patients were selected from January 1, 2015 to December 31, 2017 in the First People's Hospital of Yongkang.Low dose abdominal enhanced CT and standard dose abdominal enhanced CT were performed on patients.The image quality, radiation dose, diagnostic results of different dose abdominal enhanced CT were compared, and the consistency between low dose, standard dose abdominal enhanced CT and pathological diagnosis was analyzed.According to the pathological diagnosis, the patients with acute appendicitis were divided into simple appendicitis, suppurative appendicitis and gangrenous appendicitis.@*Results@#There was no statistically significant difference in image quality between low dose and standard dose abdominal enhanced CT(67.78% vs.74.44%, χ2=0.974, P>0.05), but the radiation dose of low dose abdominal enhanced CT [(9.28±3.05) mGy] was lower than that of standard dose [(21.34±7.86)mGy](t=13.570, P<0.05). The sensitivity, specificity and accuracy of standard dose abdominal enhanced CT in the diagnosis of acute appendicitis were 95.65%, 95.24% and 95.56%, respectively, which of low dose were 91.30%, 90.48% and 91.11%, respectively, the differences were not statistically significant(χ2=1.070, 0.359, 1.429, all P>0.05). Through consistency test analysis, it was found that in the diagnosis of acute appendicitis, there was a good consistency between the diagnosis results of low dose and standard dose abdominal enhanced CT and the pathological diagnosis results(Kappa=0.713, 0.782). The diagnostic coincidence rates of low dose abdominal enhanced CT in simple appendicitis, suppurative appendicitis and gangrenous appendicitis were 86.67%, 91.30%, 93.75%, respectively, and there were no statistically significant differences compared with the standard dose (93.33%, 95.65%, 100.00%; χ2=0.741, 0.357, 1.032, all P>0.05).@*Conclusion@#The accuracy, sensitivity and specificity of low dose abdominal enhanced CT in the diagnosis of acute appendicitis are comparable to those of standard dose abdominal enhanced CT, but low dose CT can reduce the radiation dose and is more safe.
ABSTRACT
Objective To study the clinical value of multi－slice spiral CT angiography in the diagnosis of abdominal tumors. Methods From January 2015 to December 2017,90 patients with abdominal neoplasms in the First People＇s Hospital of Yongkang were divided into two groups according to double－blind randomized method,with 45 patients in each group. The patients with conventional CT scan were included in the control group,and the patients with multislice spiral CT angiography were selected as the observation group. The scan results,invasion range and location of abdominal tumor, vascular display and perfusion parameters were compared between the two groups. Results The diagnostic accuracy of abdominal tumor and invasion range in the observation group ( 93. 33% , 80. 00% ) was higher than those of the control group(χ2=5. 414,5. 086,all P＜0. 05). The proportions of abnormal thickening of one supply artery(27 cases) and two blood supply arteries(8 cases) in patients with malignant and borderline venereal lesions with normal diameter were higher than those of patients with benign lesions(χ2=31. 765, 8. 372,all P＜0. 05). The contrast medium through time,blood flow,blood volume and capillary surface permeability in patients with benign lesions and normal average diameter were (10. 55 ± 3. 02) s,(21. 54 ± 5. 58) mL·min－1· 100 g－1,(4.04 ±0.76) mL/100 g,(10.16 ±2.73)mL·min－1·100 g－1,respectively,which were lower than those of patients with malignant and border venereal focal lesions (t =3. 016,5. 005,4. 982,6. 989,all P ＜0. 05). Conclusion Application of multislice spiral CT angiography in the clinical diagnosis of abdominal tumors has high accuracy and can better display the abnormal condition of blood vessels.