Hosseini Alireza, Omidian Javad, Nazarzadeh Reza
Department of General Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2018 Jul 20;7:113. doi: 10.4103/abr.abr_79_18. eCollection 2018.
Acute appendicitis is one of the most commonly diagnosed surgical diseases that its accurate diagnosis is still a problem, and there is no certainty. Ultrasound is recommended for diagnosis of appendicitis as an easy and noninvasive method. Therefore, due to the spread of disease and the urgent need to accurately diagnose in all educational centers, we decided to determine the diagnostic value of this inclusive method in identifying acute appendicitis.
This is a descriptive cross-sectional research that was conducted on 540 patients referring to Educational Center of Ayatollah Kashani Hospital. All individuals suspected to appendicitis, and undergone ultrasound was included in the study, and then the result of ultrasound was compared to the obvious pathological results. Data were entered into statistical software of SPSS 20 and were analyzed.
According to the ultrasound findings, appendicitis was diagnosed as negative in 351 ones and positive in 189 ones. Ultrasound sensitivity in the diagnosis of appendicitis was 37.1%, while its specificity was 87.2%. The positive predictive value was 96.8% and the negative predictive value was only 11.7%.
Considering very low-negative predictive value in educational centers, it is suggested that ultrasound is done for diagnosis of appendicitis only in complicated cases of appendicitis and differential diagnose (kidney stones, and ovarian cysts). In addition, it is recommended that routine ultrasound be avoided for all patients.
急性阑尾炎是最常被诊断出的外科疾病之一，其准确诊断仍是个问题，尚无定论。超声作为一种简便且无创的方法，被推荐用于阑尾炎的诊断。因此，鉴于疾病的传播以及所有教育中心对准确诊断的迫切需求，我们决定确定这种全面方法在识别急性阑尾炎方面的诊断价值。
这是一项描述性横断面研究，对转诊至卡尚尼阿亚图拉医院教育中心的540例患者进行。所有疑似阑尾炎且接受了超声检查的个体均纳入研究，然后将超声检查结果与明确的病理结果进行比较。数据录入SPSS 20统计软件并进行分析。
根据超声检查结果，351例阑尾炎诊断为阴性，189例诊断为阳性。超声诊断阑尾炎的敏感性为37.1%，而特异性为87.2%。阳性预测值为96.8%，阴性预测值仅为11.7%。
考虑到教育中心的阴性预测值非常低，建议仅在阑尾炎复杂病例及鉴别诊断（肾结石和卵巢囊肿）时进行超声检查以诊断阑尾炎。此外，建议避免对所有患者进行常规超声检查。
