GIÁ TRỊ CỦA CÁC DẤU HIỆU CẮT LỚP VI TÍNH TRONG CHẨN ĐOÁN VIÊM RUỘT THỪA CẤP

Abstract

Objective: study the value of CT signs in the diagnosis of acute appendicitis. Subjects and methods: A comparing cross-sectional descriptive study of 55 patients with clinically suspected appendicitis, of which 25 patients were confirmed appendicitis after surgery, underwent abdominal CT scan at Viet-Duc Hospital from April to October 2022. Results: 16 men and 39 women, mean age was 41.75 ± 21.30 years old (from 5 to 93). The CT characteristics of acute appendicitis included enlarged appendix diameter >6mm (Se: 100%, NPP: 100%, Acc: 80% with OR: 3.2%; p<0.01), appendiceal wall thickening ≥ 3mm (Se: 84%, NPV: 85.2%, Acc: 80% and OR: 17.2; p<0.01), appendiceal intraluminal fluid (Se: 80%, NPV: 77.3% and OR: 5.2%; p<0.01), appendiceal fecal stones (Sp: 90%, PPV: 80% and OR: 8.3%; p<0.01), appendiceal intraluminal air is a negative sign (Sp: 83.3%, NPV: 80.6%, Acc: 80% and OR: 0.06; p<0.01). Peri-appendiceal abnormal CT signs including fat stranding (Se: 88%, Sp: 80%, Acc: 83.6% and OR: 29.3; p<0.01), strongly enhanced peri-appendiceal peritoneum (Se: 92%, Sp: 86.7%, Acc: 89.1% and OR: 74.7; p<0.01). The value of CT scans in the diagnosis of acute appendicitis had Se: 96%, Sp: 86.7%, Acc: 92.7%. Conclusion: The CT signs are specific and reliable in the diagnosis of acute appendicitis.