염증이 있는 충수돌기의 발견에 어떤 요소가 영향을 미치는가? 초음파와 CT에서의 비교 평가 = Which Factors Influence the Detection of an Inflamed Appendix: Comparative Assessment of Ultrasonography and CT

국문 초록 (Abstract)

목적 :염증이 있는 충수돌기의 발견에 영향을 주는 요소들을 초음파와 CT에서 비교 평가하고자하였다.
대 상 및 방 법 : 급성충수돌기염으로 확진된 환자들 중 수술전에 초음파와 CT를 동시에 시행받은58명의 환자 (42명은 천공성 충수돌기염, 16명은 비천공성 충수돌기염)를 대상으로 하였다.음파와 CT를 비교하였다. 또한, 충수돌기의 위치, 하복부 장간막 지방의 양, 맹장벽의 비후유무, 맹장주위 액체 저류 및 농양의 유무 등에 따라 염증이 있는 충수돌기의 발견율에 차이가 있는지를 초음파와 CT에서 비교하였다.
결과 : 대상환자에서 급성충수돌기염의 초음파와 CT의 진단율은 모두 93.1% 로서 차이가 없었다.학적인 차이는 없었다 (p > 0.05). 충수돌기가 골반쪽으로 위치하는 경우와 맹장주위 액체저류 및 농양이 있을 경우 초음파가 CT보다 유의하게 염증이 있는 충수돌기를 발견하였다(p < 0.05). 그 외의 충수돌기 위치나 하복부 장간막 지방의 양, 맹장벽의 비후는 염증이 있는 충수돌기 발견에 있어서 초음파와 CT간에 유의한 영향을 끼치지 않았다 (p > 0.05).
결론 : 초음파는 급성충수돌기염의 진단에 있어서 CT만큼 유용하다. 특히 충수돌기가 골반쪽으로 위치하는 경우와 맹장주위 액체 저류 및 농양이 있을 경우 초음파가 CT보다 염증이 있는 충수돌기 발견에 유용하다.

다국어 초록 (Multilingual Abstract)

PURPOSE : To compare and assess factors influencing the detection of an inflamed appendix by both ultrasonography (US) and CT.
MATERIALS and METHODS : We retrospectively analyzed US and CT findings of 58 patients with confirmed acute appendicitis
(42 patients with perforation and 16 patients without perforation), in which both preoperative US and
CT scans were performed. We compared the use of US and CT for the diagnostic accuracy of acute appendicitis, and determined the detection rate for an inflamed appendix. According to the location of the appendix, the amount of mesenteric fat content in lower abdominal cavity, the presence of cecal wall thickening, and the presence of pericecal fluid or an abscess, the use of US and CT were compared for the determination of the detection rate of an inflamed appendix.
RESULTS : The diagnostic accuracies for US and CT for acute appendicitis in our study group were both 93.1%, and there was no difference between the use of the two modalities. Although the detection rate of an inflamed appendix was slightly higher for US (93.1%) than for CT (84.5%), the difference between the use of the two modalities was not significant (p > 0.05). There was no significant difference in the detection rate of an inflamed appendix between the use of US and CT according to location of appendix, the amount of mesenteric fat content and the presence of cecal wall thickening. A pelvic location of the inflamed appendix and the presence of pericecal
fluid or an abscess, were factors that significantly increased the detection rate for US than for CT (p < 0.05).
CONCLUSION : The use of US for diagnosis of acute appendicitis is as useful as the use of CT. US is especially useful to detect an inflamed appendix more effectively than CT in cases where the appendix is in a pelvic location and
presents with pericecal fluid or an abscess.

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