多排螺旋CT鉴别急性胆囊炎的效果分析

曾乐 袁苗苗

【摘要】目的：探讨与分析多排螺旋CT鉴别急性胆囊炎的效果。方法：2019年8月—2023年5月选择在我院接受治疗的98例疑似急性胆囊炎或胆囊结石患者作为研究对象，所有患者都给予多排螺旋CT检查，记录成像特征。所有患者都给予手术检查，都以手术检查结果为诊断金标准，判断CT诊断效果。结果：在98例患者中，手术判断为急性胆囊炎68例，占比69.4%，胆囊结石30例。急性胆囊炎的胆囊壁厚度、黏膜线完整性、胆道梗阻位置、胆囊形态等与胆囊结石患者对比有明显差异（P<0.05）。在98例患者中，多排螺旋CT判断为急性胆囊炎65例，胆囊结石33例，多排螺旋CT鉴别急性胆囊炎的敏感性与特异性为94.1%（64/68）、96.7%（29/30）。结论：相对于胆囊结石，急性胆囊炎患者的多排螺旋CT可表现为胆囊壁厚度、黏膜线完整性、胆道梗阻位置、胆囊形态的差异，多排螺旋CT鉴别诊断急性胆囊炎具有很高的敏感性与特异性。

【关键词】胆囊结石；急性胆囊炎；多排螺旋CT；胆囊壁厚度；胆道梗阻位置；诊断敏感性

Analysis of the effect of multi row spiral CT in distinguishing acute cholecystitis

ZENG Le， YUAN Miaomiao

Xian Sanqiao Jingcheng Hospital， Xian， Shaanxi 710086， China

【Abstract】Objective： To explore and analyze the effect of multi row spiral CT in distinguishing acute cholecystitis. Methods： 98 patients with suspected acute cholecystitis or gallstones who received treatment at our hospital from August 2019 to May 2023 were selected as the study subjects. All patients underwent multi row spiral CT examination and recorded imaging features. All patients were subjected to surgical examination， and the results of the surgical examination were used as the diagnostic gold standard to determine the effectiveness of CT diagnosis. Results： Among the 98 patients， 68 cases （69.4%） were diagnosed as acute cholecystitis by surgery， and 30 cases were diagnosed with gallbladder stones. There were significant differences in gallbladder wall thickness， mucosal integrity， location of biliary obstruction， and gallbladder morphology between acute cholecystitis and patients with gallstones （P<0.05）. Among 98 patients， 65 were diagnosed with acute cholecystitis and 33 with gallbladder stones using multi row spiral CT. The sensitivity and specificity of multi row spiral CT in distinguishing acute cholecystitis were 94.1% （64/68） and 96.7% （29/30）， respectively. Conclusion： Compared to gallstones， multi row spiral CT in patients with acute cholecystitis can exhibit differences in gallbladder wall thickness， mucosal integrity， location of biliary obstruction， and gallbladder morphology. Multi row spiral CT has high sensitivity and specificity in differential diagnosis of acute cholecystitis.

【Key Words】Gallbladder stones； Acute cholecystitis； Multi row spiral CT； Gallbladder wall thickness； Location of biliary obstruction； Diagnostic sensitivity

膽道系统高发病变有胆囊炎与胆囊结石等，尤其是急性胆囊炎与胆囊结石在临床上都具有病情发展速度快、疾病严重、腹部疼痛、内脏疼痛、发病突然等特点，在早期鉴别上比较困难[1]。胆囊结石多需要采用手术治疗，而急性胆囊炎患者采用保守治疗就能取得比较好的效果，为此加强早期诊断具有重要价值[2]。如今，在医学领域，影像技术越来越先进，急性胆囊炎与胆囊结石的检出率与准确率也在逐渐提高，但是混淆诊断情况比较常见[3-4]。多排螺旋CT具有图像后处理技术强、快速容积扫描等特点，可清楚地显示人体三维结构。多排螺旋 CT也能够清晰地展示出胆囊局部发生的特征性改变，而且具有经济、无创、简便等特点[5-6]。本文具体探讨与分析了多排螺旋CT鉴别急性胆囊炎的效果，以促进多排螺旋CT的应用。现报道如下。……