摘要 目的：分析多层螺旋CT（MSCT）征象及多平面重建（MPR）、曲面重建（CPR）对急性复杂性与非复杂性阑尾炎的鉴别价值。方法：选取2019年1月至2021年1月我院收治的并进行MSCT检查的165例急性阑尾炎患者为研究对象，收集其临床和MSCT资料，根据病理结果将其分为急性复杂性阑尾炎组（n=142）与非复杂性阑尾炎组（n=23），对比两组临床特点、重建前后MSCT征象。结果：复杂组性别、年龄、合并慢性疾病、右下腹压痛、发病时间与非复杂组比较差异不显著（P>0.05），体温、右下腹反跳痛、转移性右下腹痛、恶心呕吐、WBC、NEU和CRP水平与非复杂组比较差异有统计学意义（P<0.05）。MPR、CPR重建前后，复杂组阑尾外径增粗、阑尾周围渗出改变、阑尾穿孔、回盲部淋巴结增大、肠淤张与非复杂组比较，差异有统计学意义（P<0.05）；阑尾结石和盲肠壁增厚差异无统计学意义（P>0.05）。重建后急性阑尾炎MSCT征象中阑尾外径增粗、阑尾周围渗出显示率均高于重建前（P<0.05），阑尾结石、阑尾穿孔、回盲部淋巴结增大、肠淤张、盲肠壁增厚与重建前比较差异均无统计学意义（P>0.05）。结论：MSCT可以有效鉴别急性复杂性与非复杂性阑尾炎，采用MPR、CPR重建可以提升鉴别价值。

Objective: to analyze the differential value of multi-slice spiral CT (MSCT) signs, multiplanar reconstruction (MPR) and curved surface reconstruction (CPR) in acute complex and non complex appendicitis. Methods: 165 patients with acute appendicitis who underwent MSCT examination in our hospital from January 2019 to January 2021 were selected as the research object. Their clinical and MSCT data were collected. According to the pathological results, they were divided into acute complex appendicitis group (n = 142) and non complex appendicitis group (n = 23). The clinical characteristics and MSCT signs before and after reconstruction were compared between the two groups. Results: there were no significant differences in gender, age, chronic diseases, right lower abdominal tenderness and onset time between the complex group and the non complex group (P > 0.05). There were significant differences in body temperature, right lower abdominal rebound pain, metastatic right lower abdominal pain, nausea and vomiting, WBC, neu and CRP levels between the complex group and the non complex group (P < 0.05). Before and after MPR and CPR reconstruction, there was significant difference between the complex group and the non complex group (P < 0.05); There was no significant difference between appendiceal calculi and cecal wall thickening (P > 0.05). The MSCT signs of acute appendicitis after reconstruction were higher than those before reconstruction (P < 0.05). There was no significant difference in Appendix stone, appendix perforation, ileocecal lymph node enlargement, intestinal stasis and cecal wall thickening (P > 0.05). Conclusion: MSCT can effectively distinguish acute complex and non complex appendicitis. MPR and CPR reconstruction can improve the differential value.