Benedetto G, Ferrer Puchol M D, Llavata Solaz A
Servicio de Radiodiagnóstico, Hospital Universitario de La Ribera, Alzira, Valencia, España.
Servicio de Radiodiagnóstico, Hospital Universitario de La Ribera, Alzira, Valencia, España.
Radiologia (Engl Ed). 2019 Jan-Feb;61(1):51-59. doi: 10.1016/j.rx.2018.08.007. Epub 2018 Oct 2.
To evaluate the accuracy of ultrasonography for the diagnosis of acute appendicitis in adults, to calculate the negative appendicectomy rate in operated patients and the accuracy of pre-defined diagnostic categories and to identify statistically significant signs and symptoms of acute appendicitis in ultrasonography.
Descriptive prospective study in which we collected the findings of the urgent ultrasonographies ordered in a one-year period for adult patients with pain in the right iliac fossa (RIF), along with their symptoms. We classified them in 5 different diagnostic categories presented in the radiological report: normal appendix, non-visible appendix and no secondary signs, non-conclusive, probable appendicitis, certain appendicitis. By mean of the Stata14 software descriptive analysis, T-test and Chi-square were performed and the data were compared with the final pathological report.
Population: 139 patients (45% men, 55% women), mean age: 32,68 (15-84). Prevalence of acute appendicitis: 50,35% (70/139). Negative appendicectomy rate: 0%. Negative predictive value for the categories 1,2 and 3 taken together: 90,78%. Positive predictive value for the categories 4 and 5 taken together: 100%. Ultrasound sensibility and specificity 90% and 100%, respectively. Statistically significant signs and symptoms (p<0.05): RIF pain, fever, leukocytosis, left shift, visible appendix, non-compressibility, hyperechogenic fat, appendicolith and free fluid.
Ultrasound is very accurate for the diagnosis of acute appendicitis in adults.
评估超声检查对成人急性阑尾炎诊断的准确性，计算手术患者的阴性阑尾切除率以及预定义诊断类别的准确性，并确定超声检查中急性阑尾炎具有统计学意义的体征和症状。
描述性前瞻性研究，我们收集了在一年时间内为右下腹疼痛的成年患者安排的急诊超声检查结果及其症状。我们将其分为放射学报告中呈现的5种不同诊断类别：阑尾正常、阑尾不可见且无继发征象、不确定、可能阑尾炎、肯定阑尾炎。通过Stata14软件进行描述性分析、t检验和卡方检验，并将数据与最终病理报告进行比较。
研究对象：139例患者（男性45%，女性55%），平均年龄：32.68岁（15 - 84岁）。急性阑尾炎患病率：50.35%（70/139）。阴性阑尾切除率：0%。类别1、2和3合并的阴性预测值：90.78%。类别4和5合并的阳性预测值：100%。超声敏感性和特异性分别为90%和100%。具有统计学意义的体征和症状（p<0.05）：右下腹疼痛、发热、白细胞增多、核左移、可见阑尾、不可压缩性、高回声脂肪、阑尾结石和游离液体。
超声对成人急性阑尾炎的诊断非常准确。
