PURPOSE: To evaluate the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of ultrasonography (US), Doppler US, and laboratory findings in the diagnosis of appendicitis. MATERIALS AND METHODS: A total of 125 consecutive patients suspected of having appendicitis were prospectively included for US appendiceal (diameter enlarged to 6 mm or greater, intraluminal fluid, lack of compressibility) and periappendiceal (periileal inflammatory changes, cecal wall thickening, periileal lymph nodes, peritoneal fluid) evaluation, Doppler US evaluation (appendiceal wall signal), and laboratory assessment (leukocytosis, C-reactive protein [CRP]). Definite diagnoses were established at surgery in 61 patients, at endoscopy with biopsy in two patients, and at clinical follow-up in 62 patients. RESULTS: The prevalence of appendicitis was 46%. The appendix was identified with US in 86% of the patients, which included 96% of patients with and 72% of patients without appendicitis. The most accurate appendiceal finding for appendicitis was a diameter of 6 mm or larger, with a sensitivity, specificity, NPV, and PPV of 98%. The lack of visualization of the appendix with US had an NPV of 90%. The most accurate periappendiceal finding of appendicitis was the presence of inflammatory fat changes, with an NPV of 91% and a PPV of 76%, whereas other findings had both NPV and PPV less than 65%. An increase in both white blood cell (WBC) count and CRP level had a PPV of 71%, whereas combined normal WBC count and CRP value had an NPV of 84%. CONCLUSION: A threshold 6-mm diameter of the appendix under compression is the most accurate US finding for appendicitis and has high NPV and PPV. Copyright RSNA, 2003
PURPOSE: To evaluate the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of ultrasonography (US), Doppler US, and laboratory findings in the diagnosis of appendicitis. MATERIALS AND METHODS: A total of 125 consecutive patients suspected of having appendicitis were prospectively included for US appendiceal (diameter enlarged to 6 mm or greater, intraluminal fluid, lack of compressibility) and periappendiceal (periileal inflammatory changes, cecal wall thickening, periileal lymph nodes, peritoneal fluid) evaluation, Doppler US evaluation (appendiceal wall signal), and laboratory assessment (leukocytosis, C-reactive protein [CRP]). Definite diagnoses were established at surgery in 61 patients, at endoscopy with biopsy in two patients, and at clinical follow-up in 62 patients. RESULTS: The prevalence of appendicitis was 46%. The appendix was identified with US in 86% of the patients, which included 96% of patients with and 72% of patients without appendicitis. The most accurate appendiceal finding for appendicitis was a diameter of 6 mm or larger, with a sensitivity, specificity, NPV, and PPV of 98%. The lack of visualization of the appendix with US had an NPV of 90%. The most accurate periappendiceal finding of appendicitis was the presence of inflammatory fat changes, with an NPV of 91% and a PPV of 76%, whereas other findings had both NPV and PPV less than 65%. An increase in both white blood cell (WBC) count and CRP level had a PPV of 71%, whereas combined normal WBC count and CRP value had an NPV of 84%. CONCLUSION: A threshold 6-mm diameter of the appendix under compression is the most accurate US finding for appendicitis and has high NPV and PPV. Copyright RSNA, 2003
Authors: Oscar Vidal; Mauro Valentini; Cesar Ginestà; Josep Martí; Juan J Espert; Guerson Benarroch; Juan C García-Valdecasas Journal: Surg Endosc Date: 2009-08-19 Impact factor: 4.584
Authors: Marjolein M N Leeuwenburgh; Sebastiaan Jensch; Jan W C Gratama; Aart Spilt; Bart M Wiarda; H Wouter Van Es; Lodewijk P J Cobben; Patrick M M Bossuyt; Marja A Boermeester; Jaap Stoker Journal: Eur Radiol Date: 2013-09-08 Impact factor: 5.315
Authors: A van Randen; W Laméris; H W van Es; W ten Hove; W H Bouma; M S van Leeuwen; E M van Keulen; V P M van der Hulst; O D Henneman; P M Bossuyt; M A Boermeester; J Stoker Journal: Eur Radiol Date: 2010-01-30 Impact factor: 5.315