即時間性超音波於臨床上疑似急性闌尾炎的評估

Real-time Ultrasonography Evaluation in Clinically Suspected Acute Appendicitis

洪岳勳(Yush-Shine Hong)

《Journal of Medical Sciences》 14卷1期 (1993/08) Pp. 7-14

摘要

自1988年12月至1992年2月，共收集150例臨床上疑似急性闌尾炎病患，接受即時間性超音波掃描，男94例女56例，年齡最小7歲最大80歲，平均32歲；其中88例接受手術治療，62例保守治療。88例接受手術之病患，男54例女34例，精確率87.5％，敏感性94.9％，特異性72.4％，假陽性率9.1％，假陰性率3.4％。小於14歲之小孩共15例，其精確率86.7％，敏感性80％，特異性90％，假陽性率6.7％，假陰性率6.7％。大於60歲之老年人共20例，其精確率100％，敏感性100％，特異性100％，均無假陽性及假陰性之病患。即時間性超音波用來診斷急性闌尾炎是一種非侵犯性，快速又能進一步確診斷之方法，更有助於降低非必要性剖腹探查及闌尾切除。

關鍵字

急性闌尾炎 ； 即時間性超音波掃描儀

並列摘要

Acute appendicitis is the most common cause of surgery of abdomen, and the negative finding appendectomy ate was around 20-25% in the past 20 years. From Dec. 1983 to Feb. 1992, 150 patients with symptoms and signs suggestive of acute appendicitis, real-time ultrasonography bad been performed. 88 patients received appendectomy post scanning. The results of sonography were correlated with pathologic reports. The criteria used to make the evaluation of appendicitis are: (1) A tubular structure with one blind end. (2) Lack of peristalsis and localized location. (3) A target phenomenon in axial plane. (4) Marked dilatation of lumen and faint echogenic layer. The overall accuracy of the real-time ultrasonography studies in our series was 87.5%. The sensitivity was 94.9%. The specificity was 72.4%. There were 3 false-negative cases with a rate of 3.4%. There were 8 fasle-positive cases with a rate of 9.1%. So, in clinically suspected acute appendicitis, real-time ultrasonography is the choice of examination, and may reduce the negative laparotomy and perforation incidence.

並列關鍵字

Acute appendicitis ； real-time ultrasonograph