超声联合CT在阑尾肿瘤临床诊断中的应用价值分析OA

Objective To explore the application value of CT combined with ultrasound in the clinical diagnosis of appendiceal tumors.Methods A total of 264 patients with appendiceal lesions admitted to Kaifeng Central Hospital Affiliated to Xinxiang Medical College from January 2022 to January 2025 were retrospectively analyzed,including 132 pa-tients with appendiceal tumors as the study group and 132 patients with appendicitis as the control group.General clinical data of the two groups were collected.CT features(appendix morphology,maximum appendiceal diameter,size of ileocecal lymph nodes,pelvic effusion)and ultrasound features(appendiceal outer diameter and wall thickness,presence of nodules,presence of peripheral mesangial thickening,and changes in appendix shape including"onion skin"-like changes,"sausage"-like changes,and tip"spherical"expansion)were examined and recorded.Binary logistic regression was used to analyze whether CT combined with ultrasound features were influencing factors for the diagnosis of appendiceal tumors.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of CT,ultrasound,and their combination for ap-pendiceal tumors.Results Ultrasound examination showed that appendiceal outer diameter and wall thickness were signifi-cantly increased in the study group(t/P=7.702/＜0.001,7.201/＜0.001),and the proportions of intramural nodules,peripheral mesangial thickening,and onion skin-like and spherical shape changes of the appendix were significantly higher in the study group than in the control group(x2/P=7.343/0.007,7.076/0.008,7.443/0.006,7.072/0.008).CT examination showed that the proportions of irregular appendix shape and pelvic effusion were significantly higher in the study group than in the control group(x2/P=11.528/0.001,10.481/0.001),and the maximum appendiceal diameter and size of ileocecal lymph nodes were sig-nificantly greater in the study group than in the control group(t/P=7.198/＜0.001,7.142/＜0.001).Irregular appendix shape,pelvic effusion,increased maximum appendiceal diameter,and increased size of ileocecal lymph nodes were independent risk factors for appendiceal tumors(OR=2.033,2.165,1.446,1.529,all P＜0.05).ROC curve analysis evaluating the diagnostic effi-cacy of ultrasound,CT,and their combination for appendiceal tumors showed that the area under the curve(AUC)for ultra-sound alone was 0.808(95％CI:0.757-0.860),and the AUC for CT alone was 0.791(95％CI:0.735-0.847).The AUC of the combined diagnostic model of ultrasound and CT increased to 0.850(95％CI:0.802-0.899).The combined diagnosis of ap-pendiceal tumors was significantly better than ultrasound or CT alone(Z/P=2.436/0.025 and 3.272/0.014,respectively).Con-clusion The multimodal diagnostic strategy combining CT and ultrasound integrates the advantages of both techniques,pro-viding a more comprehensive imaging basis and facilitating early and accurate diagnosis of appendiceal tumors.