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Objective: To study the CT findings of adult acute appendicitis and modified Alvarado scoring situation with pathological types of relationships , judgment of acute appendicitis pathological type joint value of CT signs with modified Alvarado score . Methods: A retrospective analysis of Qingdao University Medical College Hospital from June 2007 to July 2010 of 452 adult patients with acute appendicitis in patients with pathologically confirmed ( by surgery ) , the list evaluate each appendicitis patients rated project ( metastatic right lower quadrant pain , loss of appetite / anorexia, nausea / vomiting , right lower quadrant tenderness , rebound tenderness, fever, leukocytosis, elevated neutrophil ratio ) and CT signs ( direct signs : appendectomy thickening , appendiceal wall thickening, cavity within bezoar effusion cavity gas accumulation ; indirect signs : the fat bundles periappendiceal levy , extraluminal fluid , extraluminal gas mesangial lymph nodes near the bowel wall thickening , small bowel obstruction ) . Different pathological types ( simple , suppurative gangrene perforation ) in patients with various indicators do univariate analysis , take all indicators are significant variables do discriminant analysis , the establishment of the Fisher discriminant function . And retrospective , forward-looking assessment . Results: rated projects of different types of pathology univariate analysis : body temperature , heart rate , respiratory rate , and white blood cell count , neutrophil count , neutrophil percentage , fever , rebound tenderness , leukocytosis , neutrophil proportion elevated modified Alvarado score score items such as the results of the difference was significant ( P lt; 0.05 ) . The CT showed effusion cavity gas accumulation tract signs of fat around the bar , extraluminal gas mesangial lymph nodes near the bowel wall thickening , small bowel obstruction in patients with different types of pathology probability differences (P lt; 0.05). Discriminant analysis , body temperature , white blood cell count , neutrophil percentage , modified Alvarado score score , the fat around bundles levy , extraluminal gas six factors into the discriminant function . Retrospective assessment of the accuracy rate of 76.52% . The new samples forward-looking assessment accuracy rate of 77.78% . Conclusion: adult appendicitis modified Alvarado score situation and CT manifestations and pathological changes of appendicitis can be used to determine the pathological type of joint , to guide the clinical treatment has a higher value .
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