T. Rettenbacher et al., Outer diameter of the vermiform appendix as a sign of acute appendicitis: Evaluation at US, RADIOLOGY, 218(3), 2001, pp. 757-762
Citations number
29
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
PURPOSE: To evaluate the usefulness and limitations of the outer diameter o
f the vermiform appendix at cross-sectional ultrasonography to confirm or r
ule out acute appendicitis.
MATERIALS AND METHODS: In a prospective study, outer appendiceal diameters
in 240 control subjects and in 278 patients suspected of having acute appen
dicitis who did (n = 98) or did not (n = 180) have acute appendicitis were
measured.
RESULTS: Outer appendiceal diameters in the control subjects ranged between
2 and 13 mm, and in 55 (23%) of 240 control subjects, diameters were 6 mm
or more. Diameters in the symptomatic patients without acute appendicitis r
anged between 2 and 11 mm, and 57 (32%) of 180 patients had diameters of 6
mm or more. Diameters of acutely inflamed appendices ranged between 6 and 3
0 mm. A diameter of 6 mm or more confirmed acute appendicitis with a sensit
ivity of 100%; a specificity of 68%; positive and negative predictive value
s of 63% and 100%, respectively; and an accuracy of 79%.
CONCLUSION: The outer appendiceal diameter of 6 mm or more as a sign of acu
te appendicitis provides high sensitivity but limited specificity. This dia
gnostic criterion is more useful in excluding acute appendicitis than in co
nfirming it.