APPENDICITIS - EFFICACY OF COLOR DOPPLER SONOGRAPHY

PURPOSE: To determine whether the addition of color Doppler ultrasonog raphy (US) to gray-scale US can help diagnose appendicitis in children . MATERIALS AND METHODS: One hundred children with suspected appendici tis were evaluated with gray-scale and color Doppler US scanning. Colo r Doppler US scans were considered positive for appendicitis if increa sed vascularity was demonstrated in the appendiceal wall and positive for perforation with abscess if a hyperemic right lower quadrant mass was seen. Gray-scale US was positive for appendicitis if a blind-endin g, noncompressible appendix larger than 6 mm in diameter, a loculated periappendiceal mass, or both were identified. RESULTS: Thirty-nine pa tients had acute appendicitis; 26 had uncomplicated appendicitis, and 13 had perforation. Acute appendicitis was identified in 34 of 39 pati ents (87%) on color Doppler US scans with a sensitivity of 87%, specif icity of 97%, and accuracy of 93%. Gray-scale US sensitivity was 87%; specificity, 92%; and accuracy, 90%. CONCLUSION: Blood flow in the app endiceal wall or right lower quadrant mass on color Doppler US scans s uggests appendicitis, but absence of flow cannot definitively distingu ish a normal from an abnormal appendix.