Sonographic detection of the normal and abnormal appendix.

Rioux, Michel

doi:10.2214/ajr.158.4.1546592

Cited by 215 publications

(157 citation statements)

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“…Studies conducted by using high frequency ultrasound in diagnosing appendicitis by Karstrup S et al [17], Brooke et al [18], Puylaert et al [19], Yousef et al [20], Schwerk et al [21], David et al [22], Wei-Ming kang et al [23], Francois Vignault et al [24], Riox [25], Crady et al [26], John et al [27] had sensitivity of 75-94%, specifi city of 73-100%, predictive value of positive test 84-94.5%, predictive value of negative test 89-96.3% and accuracy of 76-95.7%. In all the above studies sensitivity is fairly less than our diagnostic approach (Table 8).…”

Section: Discussionmentioning

confidence: 99%

Combined use of modified Alvarado score and USG in decreasing negative appendicectomy rate

et al. 2010

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Introduction Appendicitis is notorious in its ability to simulate other conditions and in the frequency it can be mimicked by other pathologies. Despite extraordinary advances in modern radiography imaging and diagnostic laboratory investigations the accurate diagnosis of acute appendicitis remains an enigmatic challenge. Of the various commonly used diagnostic aids for appendicitis, no single test can reduce the rate of negative appendicectomy to zero.

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Section: Discussionmentioning

confidence: 99%

Combined use of modified Alvarado score and USG in decreasing negative appendicectomy rate

et al. 2010

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“…A transverse diameter of more than 6 mm is a reproducible index suggesting appendicitis (21,22). The reported sensitivity of US in diagnosing acute appendicitis ranges from 75% to 90%, the specificity and accuracy are greater than 90% (20,(22)(23)(24)(25). AbuYousef et al (23) reported a specificity of 95%, a sensitivity of 80%, and an accuracy of 90% in 68 consecutive cases.…”

Section: Discussionmentioning

confidence: 99%

“…The retrocecal appendix is hard to visualize by US. Approximately 30% of cases missed on US examination are attributed to the appendix being in the retrocecal position (22)(23)(24)(25). The appendix in the obese patient is difficult to demonstrate by US.…”

Section: Discussionmentioning

confidence: 99%

MR imaging of the normal appendix and acute appendicitis

Nitta

Takahashi

Furukawa

et al. 2005

Magnetic Resonance Imaging

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Purpose: To describe the MR appearance of the normal appendix and the MR imaging characteristics of acute appendicitis with correlation to pathological severity. Materials and Methods:A total of 20 volunteers participated in this study to demonstrate normal appendices by MR imaging. A total of 37 consecutive patients with clinically diagnosed acute appendicitis were also scanned. T1-weighted (T1WI) spin-echo images, T2-weighted (T2WI) fast spin-echo, and fat-suppressed spectral presaturation inversion recovery T2-weighted (T2SPIR) fast spin-echo images were obtained. The MR criteria for considering acute appendicitis were as follows: 1) thickening of the appendiceal wall with high intensity on T2WI or T2SPIR; 2) dilated lumen filled with high intensity material on T2WI or T2SPIR; and 3) increased intensity of periappendiceal tissue on T2WI or T2SPIR. Results:The visibility of a normal appendix on MR imaging was 90% (18/20). It appeared as a cord-like structure of medium intensity without fluid collection in the lumen. A total of 30 cases with clinically diagnosed acute appendicitis had positive MR findings and all except one were pathologically proven. The one had cecal diverticulitis. These cases demonstrated filled lumen, with a hypointense wall on T1WI and slightly hyperintense on T2WI or T2SPIR. MR findings correlated well with pathological severity, especially a thicker wall, periappendiceal high intensity, and ascites were useful for suspecting severe appendicitis. Conclusion:Correct diagnosis of acute appendicitis was obtained with MRI, and correlated well with its pathological severity. MRI is a powerful alternative for diagnosing acute appendicitis especially for the patients in whom the radiation is major concern. ACUTE APPENDICITIS is one of the most common abdominal diseases and presents as an acute abdomen. The diagnosis is usually based on clinical and laboratory findings, however, approximately one-third of patients with acute appendicitis present with atypical clinical symptoms. This confusion leads to a high prevalence of unnecessary laparotomy, reported at 6% to 16% (1-5). The other cases demonstrate atypical and nonspecific symptoms shared with other abdominal diseases including cholecystitis, gastritis, enterocolitis, diverticulitis, mesenteric adenitis, gynecological disease (e.g., pelvic inflammatory disease [PID], tubo-ovarian abscess, ovarian cyst or torsion, endometriosis, degenerating uterine leiomyoma), and urological disorders (6 -12). In such clinically questionable cases, it is not uncommon that radiological evaluations provide useful information in making a differential diagnosis. An appropriate imaging procedure can prevent surgery delays and minimize the rate of negative laparotomies. Currently, the imaging modalities chosen to demonstrate an inflamed appendix, as well as its complications, are ultrasound (US) and computed tomography (CT). However, MR has not been applied to acute appendicitis.The first objective of this study was to describe the MR appearances of the normal appe...

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“…O resultado não conclusivo é ocasionalmente um problema na ultra-sonografia abdominal, entretanto deve ser categorizado como negativo com respeito à apendicite [24][25][26] .…”

Section: Discussionunclassified

“…Os doentes com sinais clínicos característicos de apendicite aguda são enviados diretamente para tratamento cirúrgico, sem realizar de exame ultra-sonográfico, demonstrando que a população estudada não representa um grupo homogêneo de pacientes 24 . Na presente série, apenas aqueles nos quais o diagnóstico clínico não foi possí-vel, foram encaminhados para exame ultra-sonográfico.…”

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Avaliação ultra-sonográfica da apendicite aguda

Torres

Lins

Nunes

et al. 2001

Rev. Col. Bras. Cir.

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RESUMO: Objetivo:A apendicite aguda é a mais comum urgência cirúrgica abdominal. Na tentativa de aumentar a acurácia diagnóstica a ultra-sonografia abdominal tem sido observada como método sensível e específico. O presente estudo tem por objetivo avaliar a ultra-sonografia do abdome no diagnóstico de apendicite aguda. Méto-do: Um total de 138 pacientes submetidos a tratamento cirúrgico com suspeita diagnóstica admitidos no Hospital Municipal Djalma Marques foi estudado no período de janeiro de 1997 a dezembro de 1998. Todos os exames foram realizados na mesma instituição e havia 87 pacientes do sexo masculino (63,0%) e 51 do sexo feminino (37,0%) com idade variando de 11 a 81 anos (média de 28,4 anos). Resultados: Dos 134 casos com diagnóstico comprovado cirurgicamente, o estudo ultra-sonográfico foi positivo em 114 (sensibilidade de 85,0%). O apêndice foi visualizado como imagem longitudinal ou transversal maior do que 7mm em 75 dos 114 achados positivos (65,8%). Conclusões: Os autores concluem que a ultra-sonografia abdominal é um instrumento valioso no diagnóstico de apendicite aguda.Descritores: Apendicite aguda; Ultra-sonografia abdominal; Diagnóstico ultra-sonográfico.Revista do Colégio Brasileiro de Cirurgiões -Vol. 28 -n o 1 -39 INTRODUÇÃOA apendicite aguda é a mais comum urgência cirúr-gica abdominal não traumática. O diagnóstico é geralmente baseado nos sintomas clínicos, principalmente com dor na fossa ilíaca direita, náuseas, vômitos, anorexia e febre, e no resultado do exame físico e de exames laboratoriais simples. Os achados mais comuns são dor à descompressão na fossa ilíaca direita, leucocitose com neutrofilia e desvio à esquerda 1-3 . Entretanto, os achados clínicos e laboratoriais podem ser inespecíficos o que contribui para taxas de 15% a 47% de laparotomias brancas em pacientes com diagnóstico de apendicite aguda. Por outro lado, a freqüência de apêndice perfurado varia de 20% a 30%, em geral determinada pelo retardo no tratamento cirúrgi-co 2,4 . O diagnóstico precoce possibilita a intervenção antes que surjam complicações, como peritonite generalizada e sepse. Na tentativa de aumentar a acurácia diagnóstica e diminuir o número de complicações alguns outros métodos de diagnóstico têm sido utilizados. A radiografia simples do abdome tem valor limitado, demonstrando anormalidades em menos de 50% dos exames e é muito inespecífica 2,4-6 .Alguns estudos têm mostrado que a ultra-sonografia abdominal é sensível e específica, aumentando a acurácia diagnóstica e reduzindo a possibilidade de regressão da doença através de um diagnóstico mais precoce e conse-

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Sonographic detection of the normal and abnormal appendix.

Cited by 215 publications

References 10 publications

Combined use of modified Alvarado score and USG in decreasing negative appendicectomy rate

Combined use of modified Alvarado score and USG in decreasing negative appendicectomy rate

MR imaging of the normal appendix and acute appendicitis

Avaliação ultra-sonográfica da apendicite aguda

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