Department of Radiology, Stanford University School of Medicine, Stanford.
Ultrasound Q. 2020 Dec;36(4):314-320. doi: 10.1097/RUQ.0000000000000536.
Diagnostic criteria for acute appendicitis using graded compression sonography have been well established based on the maximum outer diameter (MOD) of the appendix, with MOD values of <6 mm nearly always indicating normal appendices and MOD values of >8 mm nearly always indicating appendicitis. However, the "borderline-size" appendix, meaning one whose MOD lies between these ranges (ie, an appendix with MOD of 6-8 mm), presents a diagnostic dilemma because appendices in this size range are neither clearly normal nor abnormal when diagnosis is based on the MOD alone; accordingly, such borderline MOD values are diagnostically equivocal, and sonographic diagnosis must rely on sonographic findings other than the MOD. The goal of this review was to examine the additional sonographic findings that can add specificity and help enable an accurate diagnosis to be made in patients with borderline-size appendices.
基于阑尾的最大外径（MOD），使用分级加压超声诊断急性阑尾炎的标准已经得到很好的确立，阑尾 MOD 值<6mm 几乎总是表明阑尾正常，MOD 值>8mm 几乎总是表明阑尾炎。然而，“临界大小”的阑尾，是指 MOD 值介于这两个范围之间的阑尾（即 MOD 值为 6-8mm 的阑尾），这给诊断带来了困难，因为仅根据 MOD 值来诊断，这个大小范围内的阑尾既不能明确为正常，也不能明确为异常；因此，这种临界 MOD 值的诊断结果模棱两可，超声诊断必须依赖于 MOD 以外的其他超声表现。本综述的目的是探讨可以增加特异性并有助于对临界大小阑尾患者做出准确诊断的其他超声表现。
