Aim of the study was evaluate new US signs, other than the already known, that are positive correlated with histophatological results and that can improve diagnostic accuracy, in case of normal maximal outer diameter, absence of periappendicular fluid or clinical doubts Our study is based on the diagnosis of appendicitis only with the use of UltraSonography. 373 Patients underwent UltraSonography exam, performed by 2 radiologists not sharing information between them and without knowing laboratories and clinical parameters. Out of 373, we retrospectively analyzed UltraSonographic findings related to 102 Patients who had positive pathological specimens. No one had perforated appendicitis. For each patient, we evaluated age, sex, maximal outer diameter, ColorDoppler positivity, periappendicular free fluid and pattern stratification (from 1 to 4 layers). Statistical analysis was performed by Matlab statistical toolbox version 2008 (MathWorks, Natick, MA, USA) for Windows at 32 bit. The most frequent stratification pattern is HYPO-HYPER-HYPO (p<0.0001) and is indipendent from maximal outer diameter. Four kinds of pluristratification (HYPO-HYPER-HYPO, HYPO-HYPER-DIS, HYPO-HYPER and HYPO-DIS) have statistically significative inverse correlation with fluid presence (p< 0.0001). In absence of fluid the presence of these stratification pattern can allow an appendicitis diagnosis. The pattern stratification has no positive correlation with age or sex and is indipendent from ColorDoppler evaluation. In conclusion, indipendently from age and sex of patients when clinical suspicion of appendicitis, expecially when maximal outer diameter and ColorDoppler signal are not conclusive and periappendicular free fluid is not present, secondary evaluation of pattern stratification can be done. This new sign could help not only radiologists during emergency procedures, but also surgeons and clinicians in case of doubts and to further standardize the exam.
Wall pluristratification: A further ultrasonographic sign of acute appendicitis
Gatta G.
2020
Abstract
Aim of the study was evaluate new US signs, other than the already known, that are positive correlated with histophatological results and that can improve diagnostic accuracy, in case of normal maximal outer diameter, absence of periappendicular fluid or clinical doubts Our study is based on the diagnosis of appendicitis only with the use of UltraSonography. 373 Patients underwent UltraSonography exam, performed by 2 radiologists not sharing information between them and without knowing laboratories and clinical parameters. Out of 373, we retrospectively analyzed UltraSonographic findings related to 102 Patients who had positive pathological specimens. No one had perforated appendicitis. For each patient, we evaluated age, sex, maximal outer diameter, ColorDoppler positivity, periappendicular free fluid and pattern stratification (from 1 to 4 layers). Statistical analysis was performed by Matlab statistical toolbox version 2008 (MathWorks, Natick, MA, USA) for Windows at 32 bit. The most frequent stratification pattern is HYPO-HYPER-HYPO (p<0.0001) and is indipendent from maximal outer diameter. Four kinds of pluristratification (HYPO-HYPER-HYPO, HYPO-HYPER-DIS, HYPO-HYPER and HYPO-DIS) have statistically significative inverse correlation with fluid presence (p< 0.0001). In absence of fluid the presence of these stratification pattern can allow an appendicitis diagnosis. The pattern stratification has no positive correlation with age or sex and is indipendent from ColorDoppler evaluation. In conclusion, indipendently from age and sex of patients when clinical suspicion of appendicitis, expecially when maximal outer diameter and ColorDoppler signal are not conclusive and periappendicular free fluid is not present, secondary evaluation of pattern stratification can be done. This new sign could help not only radiologists during emergency procedures, but also surgeons and clinicians in case of doubts and to further standardize the exam.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
