Department of Diagnostic Radiology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Department of Diagnostic Radiology, Faculty of Medicine, New Valley University, Kharga, Egypt.
Emerg Radiol. 2024 Apr;31(2):141-149. doi: 10.1007/s10140-024-02205-5. Epub 2024 Jan 24.
This study aims to evaluate the added value of duplex Doppler examination to the routinely graded compression grayscale ultrasound (US) for patients with suspected acute appendicitis (AA) in correlation with surgical management outcomes.
The study lasted from January 2020 to March 2021. Throughout that period, patients who had suspected appendicitis were included with a visible appendix in the grayscale US. These patients were categorized clinically based on Alvarado's score. They underwent graded compression grayscale US of the appendix and duplex Doppler study. Subsequently, they were assigned for non-contrast multislice computed tomography (MSCT) according to Alvarado's score and underwent either emergency appendicectomy or conservative clinical management afterward. A Student's t-test was used to determine if there were significant differences in the mean values between the groups. The diagnostic performance of spectral Doppler US for the diagnosis of AA was depicted.
Eighty-four patients with visualized color flow in the appendicular Doppler US were enrolled, with 60 (71.4%) having AA, and 24 (28.6%) not having appendicitis. Spectral Doppler criterion of PSV greater than 8.6 cm/s demonstrated a high sensitivity of 91.67% and specificity of 77.78% for patients with Alvarado score ranging from 4 to 7, and appendiceal MOD ranging from 6 to 8 mm, while a discriminatory criterion of RI greater than 0.51 had a high sensitivity of 100% and a relatively lower specificity of 66.67%.
The patients with AA have significantly higher point PSV and point RI values than those without AA and are especially useful in equivocal patients whose MODs and Alvarado scores are in the diagnostically equivocal ranges of 6-8 mm and 4-7, respectively, with the point PSV and RI demonstrating negative predictive value 87.5% and 100%.
本研究旨在评估双功能多普勒检查在疑似急性阑尾炎（AA）患者中的附加价值，这些患者的灰阶超声（US）分级压缩结果可见阑尾，并与手术治疗结果相关。
本研究于 2020 年 1 月至 2021 年 3 月进行。在此期间，将灰阶 US 可见阑尾的疑似阑尾炎患者纳入研究。这些患者根据 Alvarado 评分进行临床分类。对患者行灰阶 US 分级压缩检查和双功能多普勒检查。随后，根据 Alvarado 评分行非增强多层 CT（MSCT）检查，并随后进行急诊阑尾切除术或保守临床治疗。采用 Student t 检验确定组间均值是否存在显著差异。描绘了超声多普勒对 AA 的诊断性能。
84 例阑尾彩色血流多普勒 US 可见患者纳入研究，其中 60 例（71.4%）为 AA，24 例（28.6%）无阑尾炎。PSV 大于 8.6cm/s 的频谱多普勒标准对 Alvarado 评分为 4-7 分和阑尾 MOD 为 6-8mm 的患者具有较高的敏感性（91.67%）和特异性（77.78%），而 RI 大于 0.51 的鉴别标准具有较高的敏感性（100%）和相对较低的特异性（66.67%）。
AA 患者的 PSV 和 RI 点值明显高于非 AA 患者，尤其适用于 MOD 和 Alvarado 评分分别处于 6-8mm 和 4-7 分的诊断不确定范围内的可疑患者，PSV 和 RI 点值的阴性预测值分别为 87.5%和 100%。
