APPENDICITIS - USEFULNESS OF COLOR DOPPLER US

PURPOSE: To assess whether color Doppler ultrasonography (US) can help diagnose early acute appendicitis in appendices of equivocal size at gray-scale US. MATERIALS AND METHODS: In a retrospective study, color Doppler US findings were evaluated in 20 individuals with proved norma l appendix at barium enema examination and in 50 patients in whom path ologic findings confirmed acute appendicitis. In a prospective study, the diagnostic value of hyperemia in the wall of the appendix in diffe rentiating a normal from an inflamed appendix was evaluated in 26 pati ents with appendices of equivocal size (5-7 mm in maximal outer diamet er) at gray-scale US. RESULTS: In the retrospective study, 44 of the 5 0 patients had hyperemia at color Doppler US. The remaining six patien ts had no hyperemia, and pathologic findings confirmed gangrenous appe ndices. The 20 patients with proved normal appendix at barium enema ex amination had no detectable blood flow in the wall. In the prospective study, 10 of 26 patients had hyperemia at color Doppler US, and patho logic findings confirmed early acute appendicitis. Results of barium e nema examination (n=12) or clinical follow-up (n=4) confirmed no appen dicitis in the remaining 16 patients. CONCLUSION: Hyperemia in the wal l of the appendix at color Doppler US is a sensitive indicator for inf lammation. A simple additional color Doppler US examination may be hel pful in the diagnosis of early acute appendicitis when an appendix is well depicted and is equivocal in size at gray-scale US.