US Features of the Normal Appendix and Surrounding Area in Children

Wiersma, Fraukje; Šrámek, A.; Holscher, Herma C.

doi:10.1148/radiol.2353040086

Cited by 69 publications

(54 citation statements)

References 12 publications

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“…In our opinion, we must exploit the full potential of USG before considering CT scan as another option. If Wiersma et al [20] could demonstrate a normal appendix in children in 82 % of cases, why can we not identify a pathological appendix? What is really needed today is a dedicated appendiceal USG by an experienced radiologist for suspected cases of AA.…”

Section: Discussionmentioning

confidence: 92%

On the Role of Ultrasonography and CT Scan in the Diagnosis of Acute Appendicitis

Debnath

Kumar²,

Mathur

et al. 2012

Indian J Surg

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The purposes of this study were to revisit the utility of ultrasonography (USG) as a primary imaging modality in acute appendicitis (AA) and to establish the role of CT scan as a second-line/problem-solving modality. All cases of suspected AA were referred for urgent USG. USG was done with standard protocol for appendicitis. Limited computed tomographic (CT) scan [NCCT ± CECT (IV contrast only)] was done for the lower abdomen and pelvis where sonographic findings were equivocal. One hundred and twenty-one patients were referred for USG for suspected appendicitis. Eight-four patients underwent surgery for AA based on clinical as well as imaging findings, of whom 76 had appendicitis confirmed at histopathology. Three patients were misdiagnosed (3.6 %) on USG as appendicitis. Of 76 patients of appendicitis confirmed histopathologically, 63 (82.8 %) had features of appendicitis on USG and did not require any additional imaging modality. Of 121 patients, 12 (10 %) needed CT scan because of atypical features on USG. Of these 12 patients, seven had retrocecal appendicitis, and three high-up paracolic appendicitis. USG alone had sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 81, 88, 92.6, 71.6, and 83 %, respectively. When combined with CT scan in select cases, the sensitivity, specificity, PPV, NPV, and accuracy of combined USG + CT scan were 96 % (P 00.0014), 89 %, 93 %, 93.5 % (P00.0001), and 93 % (P00.0484), respectively. Twentyeight (23 %) patients were given alternative diagnosis on USG. Dedicated appendiceal USG should be used as a primary imaging modality in diagnosing or excluding AA. Appendiceal CT can serve as a problem-solving modality.

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Section: Discussionmentioning

confidence: 92%

On the Role of Ultrasonography and CT Scan in the Diagnosis of Acute Appendicitis

Debnath

Kumar²,

Mathur

et al. 2012

Indian J Surg

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“…The normal appendix can be seen in 82% of asymptomatic children [23]. If the normal appendix can be visualised with US, appendicitis can be safely ruled out.…”

Section: Us or Ct In Children With Suspected Appendicitis?mentioning

confidence: 99%

Imaging of acute appendicitis in children: EU versus U.S. ... or US versus CT? A European perspective

Holscher

Heij

2009

Pediatr Radiol

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“…In many cases, therefore, changes associated with abdominal pain may facilitate visualization of the appendix. Wiersma et al [30] found that in pediatric subjects, a normal appendix was depicted more frequently than in adults, possibly because there is less attenuation of the ultrasonic beam by subcutaneous fat and muscle, which are thinner in pediatric subjects [31].…”

Section: Discussionmentioning

confidence: 99%

Criteria for distinguishing the appendix from ileal segments sonographically: a different perspective

İnal¹,

Daphan²,

Bilgili³

2016

Ortadogu Tıp Derg

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Aim: We aimed to establish the new and objective criteria that can be used for distinguishing the normal or pathological appendix from ileal segments sonographically. Materials and Methods:Long diameter, short diameter, mean diameter, circularity index (CI), and diameter index (DI) in mm on transverse images of normal and pathological appendices, and the others form of the ileum, were calculated.Results: DI, CI, long dimension show high sensitivity and specificity in discrimination of the normal or pathological appendix from ileal segments.Conclusion: DI, CI, and long dimension are effective and objective criteria for distinguishing normal or pathological appendix from ileum sonographically.

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US Features of the Normal Appendix and Surrounding Area in Children

Abstract: The results of this study show that a normal appendix can be depicted with US in 82% of asymptomatic children.

Cited by 69 publications

References 12 publications

On the Role of Ultrasonography and CT Scan in the Diagnosis of Acute Appendicitis

On the Role of Ultrasonography and CT Scan in the Diagnosis of Acute Appendicitis

Imaging of acute appendicitis in children: EU versus U.S. ... or US versus CT? A European perspective

Criteria for distinguishing the appendix from ileal segments sonographically: a different perspective

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