Uzunosmanoğlu Hüseyin, Çevik Yunsur, Çorbacıoğlu Şeref Kerem, Akıncı Emine, Buluş Hakan, Ağladıoğlu Kadir
Department of Emergency Medicine, Keçiören Training and Research Hospital, Ankara-Turkey.
Ulus Travma Acil Cerrahi Derg. 2017 May;23(3):188-192. doi: 10.5505/tjtes.2016.10576.
Acute appendicitis is one of the most common causes of acute abdominal pain prompting emergency department (ED) visits. It is critical for the physicians to promptly and accurately diagnose acute appendicitis. The present study aimed to evaluate the diagnostic efficacy of Doppler ultrasonography (USG) in patients with acute appendicitis and compare this new method with other commonly used radio-diagnostic tools.
All patients who were diagnosed with acute appendicitis at the Kecioren Training and Research Hospital ED and later underwent appendectomy between October 2012 and April 2013 were included in the study. Approval from the ethics committee was obtained for this prospective study. The patients' demographic information, physical examination findings, vital signs, Alvarado scores, and laboratory and radiological exam results were recorded.
A total of 60 patients were enrolled in the study. In 46 of the 60 patients, diagnosis of acute appendicitis was confirmed by histopathology results, whereas 14 patients, diagnoses was not confirmed by lab tests. Doppler USG could detect 43 of the 46 patients as true positives, and it detected 2 of the 14 patients with negative lab results as false positives. For diagnosis of acute appendicitis, sensitivity of appendicular Doppler USG was 93%, specificity was 85%, accuracy was 91%, positive likelihood ratio was 6.5, and negative likelihood ratio was 0.08.
Doppler imaging can offer a high level of diagnostic success in patients with acute appendicitis. Appendicular Doppler USG offers a rapid and easy application without the need to expose patients to contrast medium and is superior to both USG and computed tomography. Therefore, we recommend the use of appendicular Doppler imaging as the primary radiological exam in diagnosing acute appendicitis.
急性阑尾炎是导致急诊就诊的急性腹痛最常见原因之一。对医生来说，迅速准确地诊断急性阑尾炎至关重要。本研究旨在评估多普勒超声检查（USG）对急性阑尾炎患者的诊断效能，并将这种新方法与其他常用的放射诊断工具进行比较。
纳入2012年10月至2013年4月期间在凯乔伦培训与研究医院急诊科被诊断为急性阑尾炎且随后接受阑尾切除术的所有患者。该前瞻性研究获得了伦理委员会的批准。记录患者的人口统计学信息、体格检查结果、生命体征、阿尔瓦拉多评分以及实验室和放射学检查结果。
共有60例患者纳入研究。60例患者中有46例经组织病理学结果证实为急性阑尾炎，而14例患者的诊断未得到实验室检查的证实。多普勒超声检查能将46例患者中的43例检测为真阳性，且将14例实验室检查结果为阴性的患者中的2例检测为假阳性。对于急性阑尾炎的诊断，阑尾多普勒超声检查的敏感性为93%，特异性为85%，准确性为91%，阳性似然比为6.5，阴性似然比为0.08。
多普勒成像在急性阑尾炎患者中可提供较高的诊断成功率。阑尾多普勒超声检查操作快速简便，无需让患者接触造影剂，且优于超声检查和计算机断层扫描。因此，我们建议将阑尾多普勒成像作为诊断急性阑尾炎的主要放射学检查方法。
