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目的查找引起超声对非典型急性阑尾炎误诊及漏诊的原因,以提高超声的检出率。方法回顾性的对经手术及病理证实而超声未能检出的32例急性阑尾炎的声像图表现进行分析,总结其声像图特点,找出问题所在。结果32例超声均未见典型的急性阑尾炎声像图表现,仅可表现有回盲部肠管局限性扩张及肠壁稍厚、右髂窝及肠间局限性少量积液、局部肠气增多、右下腹肿大淋巴结等超声声像图的间接表现。结论超声在诊断急性阑尾炎时不仅需凭借直接声像图表现来明确诊断,在无典型声像图表现时还要考虑其间接声像图表现,结合临床提高检出率。
Objective To investigate the causes of misdiagnosis and missed diagnosis of atypical acute appendicitis caused by ultrasound in order to improve the detection rate of ultrasound. Methods Retrospectively analyzed the sonographic features of 32 cases of acute appendicitis which were confirmed by operation and pathology but not detected by ultrasound, and summarized the features of sonography and found out the problem. Results Ultrasound in 32 cases did not show the typical acute appendicitis sonogram performance, only the limitations of the ileocecal intestinal dilation and thick wall slightly, right iliac fossa and intestine limited a small amount of effusion, local intestinal gas increased, Right lower quadrant enlarged lymph nodes and other ultrasonographic indirect manifestations. Conclusion Ultrasound in the diagnosis of acute appendicitis not only by direct ultrasound imaging to confirm the diagnosis, in the absence of typical sonographic performance should also consider its indirect sonographic performance, combined with clinical detection rate increased.