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Gastrointestinal Imaging |
1 From the Departments of Radiology and Nuclear Medicine (T.R., A.H., P.M., N.G.) and Surgery (F.T.), Hospital Barmherzige Brueder, Salzburg, Austria; the Department of Nuclear Medicine, State Hospital of Salzburg, Austria (L.R.); and the Institute of Medical Statistics, University of Vienna, Austria (B.S.). From the 1998 RSNA scientific assembly. Received March 22, 2000; revision requested May 12; revision received July 10; accepted August 15. Address correspondence to T.R., General Feursteinstr 19, A-6020, Innsbruck, Austria (e-mail: thomas.rettenbacher@uklibk.ac.at).
PURPOSE: To evaluate the usefulness and limitations of the outer diameter of the vermiform appendix at cross-sectional ultrasonography to confirm or rule 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 appendicitis 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 ranged 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 30 mm. A diameter of 6 mm or more confirmed acute appendicitis with a sensitivity of 100%; a specificity of 68%; positive and negative predictive values of 63% and 100%, respectively; and an accuracy of 79%.
CONCLUSION: The outer appendiceal diameter of 6 mm or more as a sign of acute appendicitis provides high sensitivity but limited specificity. This diagnostic criterion is more useful in excluding acute appendicitis than in confirming it.
Index terms: Appendicitis, 751.291 • Appendix, US, 751.1298 • Receiver operating characteristic (ROC) curve
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