闌尾炎的高解像力超音波檢查

Ultrasonography of Acute Appendicitis

刁翠美(Chui-Mei Tiu) ； 周宜宏(Yi-Hong Chou) ； 許重權(Chung-Chuan Hsu) ； 黃振義(Jen-I Huang) ； 李建賢(Chen-Hsen Lee) ； 邱宏仁(Hong-Jen Chiou) ； 陳信實(Sin-Sue Chen) ； 姜仁惠(Jen-Hwey Chiang) ； 張政彥(Cheng-Yen Chang) ； 于俊(Tsuen Chang)

《中華放射線醫學雜誌》 20卷4期 (1995/12) Pp. 337-343

摘要

急性闌尾炎至今仍是人類最常見的腹部急症之一。為評估高解像力即時性超音波(high-resolution real-time ultrasound, HRUS)在診斷急，l生闌尾炎及其併發症之價值，我們在五年間以HRUS一共檢查了221例右下腹疼痛而臨床診斷未能確定之患者。主要使用5.0或7.5MHz之扇形或線形探頭，並實施漸進性壓迫法(graded compression)探查。HRUS診斷出52位經手術証實有急性闌尾炎之患者中的44位，另診斷出闌尾膿瘍27位，闌尾術後併發症者14位，及其他與闌尾無關之腹部病變者有33位。HRUS檢查無異常者共128位，其中有47位患者在追蹤二個月至三年後發現確無異常（真陰性）。偽陽性與偽陰性的診斷各有2例及8例。因此HRUS診斷急性闌尾炎的敏感度、特異度及準確度各為84.6%(44/52), 97.6%(50/52)及92.5%(124/134)，而陽性預測值(positive prediction value)及陰性預測值(negative prediction value)則各為95.6%及90.9%。對無法確定原因的右下腹痛，尤其是懷疑有急性闌尾炎或其併發症時，HRUS可提供重要的臨床資料。

關鍵字

闌尾炎 ； 闌尾，超音波

並列摘要

Acute appendicitis remains one of the most common acute abdominal disorders clinically. To evaluate the usefulness of high-resolution real-time ultrasound (HRUS) in the diagnosis of acute appendicitis and its complications, we examined 221 patients with right lower abdominal pain in a period of 5 years. A 5.0- or 7.5-MHz sector/ linear transducer was used and graded compression was applied on the abdominal wall during the US examinations. US correctly diagnosed 44 of 52 patients with surgically proved acute appendicitis, 27 with appendies abscess, and 14 with post- appendectomy complications. There are true negative results (follow up for 2 months to 3years) in 47. False negative results was made in 8 patients and false positive in 2. The sensitivity of ultrasonography in the diagnosis of acute appendicitis was 84.6% (44/52); the specificity and accuracy were 97.6% (80/82) and 92.5% (124/234) respectively, and the positive prediction value and negative prediction values were 95.6% and 90.9% respectively. US was considered significantly valuable in the management of patients with right lower abdominal pain, especially in those suspected to have acute appendicities and/or its complications.

並列關鍵字

Ultrasound appendicitis ； appendix, US