比较高、低频超声检查对阑尾炎患者间接征象的显示差异，评价其在阑尾炎间接征象中的诊断价值。

选择2011年1月至2014年5月中山市人民医院收治的阑尾炎患者153例，患者临床症状体征不典型，分别采用低频超声及高频超声检查并比较间接征象，并结合手术病理及随访结果进行分析。

153例均经术后病理及复查结果确诊，其中急性单纯性阑尾炎93例，阑尾周围脓肿19例，急性蜂窝组织性阑尾炎32例，急性坏疽性阑尾炎9例，超声诊断准确性为79.1%（121/153）。采用低频及高频超声检查对回盲部水肿、阑尾肿大增粗及阑尾壁增厚等间接征象的检出差异具有统计学意义（P<0.05）。在高频超声显示的间接征象与术中所见征象的一致性检验中，所有的Kappa值均>0.8。

对临床症状体征不典型的阑尾炎患者，高频超声检查可提高间接征象的显示率，低频联合高频超声检查可以提高阑尾炎的诊断准确性。

To compare the difference of indirect ultrasound signs by high and low frequency ultrasonography and to evaluate the value on the diagnosis of appendicitis.

The clinical data of one hundred and fifty-three patients with appendicitis admitted to Zhongshan City People's Hospital from January 2011 to May 2014 were retrospectively analyzed. The clinical symptoms and signs of the patients were atypical and they were examined by low and high frequency ultrasonography. The indirect ultrasound signs were analyzed and compared with pathology results and clinical follow-up.

The diagnostic accuracy of ultrasonography in 153 cases was 79.1% (121/153). There were 93 cases of simple appendicitis, 19 cases of appendiceal abscess, 32 of acute cellular appendicitis, 9 of acute gangrenous appendicitis, and the diagnosis was confirmed by pathology and follow-up. The low frequency and high frequency ultrasonography showed significant differences in the detection of indirect signs such as edema of ileocecal, enlargement of appendix and thickening of appendix wall (P<0.05). All of the Kappa values were greater than 0.8 in the coincidence test between the indirect signs of high-frequency ultrasound and the signs seen during surgery.

For appendicitis patients with atypical clinical symptoms and signs, high frequency ultrasonography can improve the detection rate, and improve the diagnostic accuracy of appendicitis when combined with low frequency ultrasound.