DOI: 10.1097/01.ruq.0000277023.69640.fe
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Issn Print: 0894-8771
Publication Date: 2007/06/01
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Excerpt
This prospective study compared compression ultrasound and noncontrast spiral computed tomography (CT) in the evaluation of 58 patients with clinically suspected acute appendicitis.
For the ultrasound examinations, 5- to 7.5-MHz linear and 3-MHz curved transducers were use. Scanning commenced in the right upper quadrant and continued inferiorly to the right lower quadrant using graded compression to displace gas-containing bowel loops and to better visualize the appendix. Standard morphological criteria were used to diagnose an abnormal appendix, including directly visualizing an inflamed appendix, seen as a noncompressible appendix with a diameter of 6 mm or more and echogenic noncompressible periappendiceal inflamed fat with or without an appendicolith.
The CT and ultrasound findings were scored as (1) appendicitis, (2) no appendicitis, or (3) another diagnosis. The decision whether to operate was based on clinical findings and not imaging findings; ultimately, 52 patients had surgical confirmation of the findings.
Overall, the sensitivity of ultrasound and CT was 67.3% and 95.8%, respectively, specificity was 100% and 75%, and accuracy was 71.2% and 90.3%. The CT was found to be useful in offering alternative diagnoses such as tubo-ovarian abscess, ureteral calculus, and mesenteric adenopathy. Of note, most patients in this series were adults.
