Research Article
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Criteria for distinguishing the appendix from ileal segments sonographically: a different perspective

Year 2016, Volume: 8 Issue: 4, 200 - 206, 31.12.2016
https://doi.org/10.21601/ortadogutipdergisi.267252

Abstract

Introduction:
We aimed to
establish the new
and objective criteria that can be used for distinguishing the normal or
pathological appendix from ileal segments sonographically.

Materials and methods: Long diameter, short diameter, mean diameter,
circularity index (CI), and diameter index (DI) in mm on transverse images of
normal and pathological appendices, and the others form of the ileum, were
calculated.

Results: DI, CI, long dimension show high sensitivity and
specificity in discrimination of the normal or pathological appendix from ileal
segments.







Conclusion:
DI, CI, and long dimension are effective and objective criteria for
distinguishing normal or pathological appendix from ileum sonographically.

References

  • 1. Bendeck SE, Nino-Murcia M, Berry GJ, Jeffrey RB Jr. Imaging for suspected appendicitis: negative appendectomy and perforation rates. Radiology. 2002;225:131-6.
  • 2. Andersson RE, Hugander A, Thulin AGJ. Diagnostic accuracy and perforation rate in appendicitis: association with age and sex of the patient and with appendectomy rate. Eur J Surg. 1992;158:37-41.
  • 3. Velanovich V, Harkabus MA, Tapia FV, Gusz JR, Vallance SR. When it's not appendicitis. Am Surg. 1998;64:7-11.
  • 4. Rao PM, Rhea JT, Rattner DW, Venus LG, Novelline RA. Introduction of appendiceal CT: impact on negative appendectomy and appendiceal perforation rates. Ann Surg. 1999;229:344-9.
  • 5. Kan JH, Fines BP, Funaki B. Conventional and hydrocolonic US of the appendix with CT correlation performed by on-call radiology residents. Acad Radiol. 2001;8:1208-14.
  • 6. Lane MJ, Liu DM, Huynh MD, Jeffrey RB Jr, Mindelzun RE, et al. Suspected acute appendicitis: nonenhanced helical CT in 300 consecutive patients. Radiology. 1999;213:341-6.
  • 7. Yetkin G, Basak M, Isgor A, Kebudi A, Akgun I. Can negative appendectomy rate be decreased by using spiral computed tomography without contrast material? Acta Chir Belg. 2002;102:334-7.
  • 8. Raman SS, Lu DS, Kadell BM, Vodopich DJ, Sayre J, et al. Accuracy of nonfocused helical CT for the diagnosis of acute appendicitis: a 5-year review. AJR Am J Roentgenol. 2002;179:1319-25.
  • 9. Balthazar EJ, Birnbaum BA, Yee J, Megibow AJ, Roshkow J, et al. Acute appendicitis: CT and US correlation in 100 patients. Radiology. 1994;190:31-5.
  • 10. Horton MD, Counter SF, Florence MG, Hart MJ. A prospective trial of computed tomography and ultrasonography for diagnosing appendicitis in the atypical patient. Am J Surg. 2000;179:379-81.
  • 11. Fujii Y, Hata J, Futagami K, Hamada T, Mitsuoka H, et al. Ultrasonography improves diagnostic accuracy of acute appendicitis and provides cost savings to hospitals in Japan. J Ultrasound Med. 2000;19:409-14.
  • 12. Chen SC, Chen KM, Wang SM, Chang KJ. Abdominal sonography screening of clinically diagnosed or suspected appendicitis before surgery. World J Surg. 1998;22:449-52.
  • 13. Uebel P, Weiss H, Trimborn CP, Fiedler L, Bersch W. Ultrasound diagnosis of acute appendicitis--possibilities and limits of the method--results of prospective and retrospective clinical studies. Ultraschall Med. 1996;17:100-5.
  • 14. Schwerk WB. Ultrasound first in acute appendix? Unnecessary laparotomies can often be avoided. MMV Fortschr Med. 2000;142:29-32.
  • 15. Rettenbacher T, Hollerweger A, Gritzmann N, Gotwald T, Schwamberger K, et al. Appendicitis: should diagnostic imaging be performed if the clinical presentation is highly suggestive of the disease? Gastroenterology. 2002;123:992-8.
  • 16. Himeno S, Yasuda S, Oida Y, Mukoyama S, Nishi T, et al. Ultrasonography for the diagnosis of acute appendicitis. Tokaij Exp Clin Med. 2003;28:39-44.
  • 17. Rettenbacher T, Hollerweger A, Macheiner P, Gritzmann N. Ultrasonography of the normal vermiform appendix. Ultraschall Med. 1997;18:139-42.
  • 18. Lee JH, Jeong YK, Hwang JC, Ham SY, Yang SO. Graded compression sonography with adjuvant use of a posterior manual compression technique in the sonographic diagnosis of acute appendicitis. AJR Am J Roentgenol. 2002;178:863-8.
  • 19. Lehmann D, Uebel P, Weiss H, Fiedler L, Bersch W. Sonographic representation of the normal and acute inflamed appendix--in patients with right-sided abdominal pain. Ultraschall Med. 2000;21:101-6.
  • 20. Rioux M. Sonographic detection of the normal and abnormal appendix. AJR Am J Roentgenol. 1992;158:773-8.
  • 21. Tarantino L, Giorgio A, de Stefano G, Scala V, Esposito F, et al. Acute appendicitis mimicking infectious enteritis: diagnostic value of sonography. J Ultrasound Med. 2003;22:945-50.
  • 22. Simonovsky V. Detection of acute appendicitis using ultrasonography. Rozhl Chir. 2000;79:215-20.
  • 23. Gough IR, Morris MI, Pertnikovs EI, Murray MR, Smith MB, et al. Consequences of removal of a "normal" appendix. Med J Aust. 1983;1:370-2.
  • 24. Walker SJ, West CR, Colmer MR. Acute appendicitis: does removal of a normal appendix matter, what is the value of diagnostic accuracy and is surgical delay important? Ann R Coll Surg Engl. 1995;77;358-63.
  • 25. Rioux M. Sonographic detection of the normal and abnormal appendix. AJR Am J Roentgenol. 1992;158:773-8.
  • 26. Zakaria O, Sultan TA, Khalil TH, Wahba T. Role of clinical judgment and tissue harmonic imaging ultrasonography in diagnosis of paediatric acute appendicitis. World J Emerg Surg. 2011;6:39.
  • 27. Rettenbacher T, Hollerweger A, Macheiner P, Rettenbacher L, Tomaselli F, et al. Outer diameter of the vermiform appendix as a sign of acute appendicitis: evaluation at US. Radiology. 2001;218:757-62.
  • 28. Menten R, Lebecque P, Saint-Martin C, Clapuyt P. Outer diameter of the vermiform appendix: not a valid sonographic criterion for acute appendicitis in patients with cystic fibrosis. AJR Am J Roentgenol. 2005;184:1901-3.
  • 29. Rettenbacher T, Hollerweger A, Macheiner P, Gritzmann N, Daniaux M, et al. Ovoid shape of the vermiform appendix: a criterion to exclude acute appendicitis--evaluation with US. Radiology. 2003;226:95-100.
  • 30. Wiersma F, Srámek A, Holscher HC. US features of the normal appendix and surrounding area in children. Radiology. 2005;235:1018-22.
  • 31. Yabunaka K, Katsuda T, Sanada S, Fukutomi T. Sonographic appearance of the normal appendix in adults. J Ultrasound Med. 2007;26:37-43.
  • 32. Jeffrey RB, Jain KA, Nghiem HV. Sonographic diagnosis of acute appendicitis: interpretive pitfalls. AJR Am J Roentgenol. 1994;162:55-9.
  • 33. Poljak A, Jeffrey RB Jr, Kernberg ME. The gas-containing appendix: potential sonographic pitfall in the diagnosis of acute appendicitis. J Ultrasound Med. 1991;10:625-8.
  • 34. Levine CD, Aizenstein O, Wachsberg RH. Pitfalls in the CT diagnosis of appendicitis. Br J Radiol. 2004;77:792-9.

Apendiksin ileal segmentlerden sonografik olarak ayırtedilebilmesi için gerekli kriterler: farklı bir bakış açısı

Year 2016, Volume: 8 Issue: 4, 200 - 206, 31.12.2016
https://doi.org/10.21601/ortadogutipdergisi.267252

Abstract

Amaç: Biz bu çalışmada normal veya patolojik apendiksin
ileal segmentlerden sonografik olarak ayırtedilebilmesi için gerekli yeni ve objektif
kriterler tespit etmeyi amaçladık.

Materyal ve Metodlar: Normal ve patolojik apendikslerin, ileumun ikinci ve
üçüncü formlarının transvers ultrasonografik kesitleri üzerinde milimetrik
olarak uzun çap, kısa çap, ortalama çap, dairesellik indeksi, ve çap indeksi
hesaplandı.

Bulgular: Dairesellik indeksi, sirkülarite indeksi ve uzun çap,
normal veya patolojik apendiksin ileal segmentlerden ayırtedilmesinde yüksek
oranda sensitivite ve spesifisite gösterdi.







Sonuç: Dairesellik indeksi, sirkülarite indeksi ve uzun çap
normal veya patolojik apendiksin ileumdan ultrasonografik olarak
ayırtedilmesinde objektif ve etkin kriterlerdir.



References

  • 1. Bendeck SE, Nino-Murcia M, Berry GJ, Jeffrey RB Jr. Imaging for suspected appendicitis: negative appendectomy and perforation rates. Radiology. 2002;225:131-6.
  • 2. Andersson RE, Hugander A, Thulin AGJ. Diagnostic accuracy and perforation rate in appendicitis: association with age and sex of the patient and with appendectomy rate. Eur J Surg. 1992;158:37-41.
  • 3. Velanovich V, Harkabus MA, Tapia FV, Gusz JR, Vallance SR. When it's not appendicitis. Am Surg. 1998;64:7-11.
  • 4. Rao PM, Rhea JT, Rattner DW, Venus LG, Novelline RA. Introduction of appendiceal CT: impact on negative appendectomy and appendiceal perforation rates. Ann Surg. 1999;229:344-9.
  • 5. Kan JH, Fines BP, Funaki B. Conventional and hydrocolonic US of the appendix with CT correlation performed by on-call radiology residents. Acad Radiol. 2001;8:1208-14.
  • 6. Lane MJ, Liu DM, Huynh MD, Jeffrey RB Jr, Mindelzun RE, et al. Suspected acute appendicitis: nonenhanced helical CT in 300 consecutive patients. Radiology. 1999;213:341-6.
  • 7. Yetkin G, Basak M, Isgor A, Kebudi A, Akgun I. Can negative appendectomy rate be decreased by using spiral computed tomography without contrast material? Acta Chir Belg. 2002;102:334-7.
  • 8. Raman SS, Lu DS, Kadell BM, Vodopich DJ, Sayre J, et al. Accuracy of nonfocused helical CT for the diagnosis of acute appendicitis: a 5-year review. AJR Am J Roentgenol. 2002;179:1319-25.
  • 9. Balthazar EJ, Birnbaum BA, Yee J, Megibow AJ, Roshkow J, et al. Acute appendicitis: CT and US correlation in 100 patients. Radiology. 1994;190:31-5.
  • 10. Horton MD, Counter SF, Florence MG, Hart MJ. A prospective trial of computed tomography and ultrasonography for diagnosing appendicitis in the atypical patient. Am J Surg. 2000;179:379-81.
  • 11. Fujii Y, Hata J, Futagami K, Hamada T, Mitsuoka H, et al. Ultrasonography improves diagnostic accuracy of acute appendicitis and provides cost savings to hospitals in Japan. J Ultrasound Med. 2000;19:409-14.
  • 12. Chen SC, Chen KM, Wang SM, Chang KJ. Abdominal sonography screening of clinically diagnosed or suspected appendicitis before surgery. World J Surg. 1998;22:449-52.
  • 13. Uebel P, Weiss H, Trimborn CP, Fiedler L, Bersch W. Ultrasound diagnosis of acute appendicitis--possibilities and limits of the method--results of prospective and retrospective clinical studies. Ultraschall Med. 1996;17:100-5.
  • 14. Schwerk WB. Ultrasound first in acute appendix? Unnecessary laparotomies can often be avoided. MMV Fortschr Med. 2000;142:29-32.
  • 15. Rettenbacher T, Hollerweger A, Gritzmann N, Gotwald T, Schwamberger K, et al. Appendicitis: should diagnostic imaging be performed if the clinical presentation is highly suggestive of the disease? Gastroenterology. 2002;123:992-8.
  • 16. Himeno S, Yasuda S, Oida Y, Mukoyama S, Nishi T, et al. Ultrasonography for the diagnosis of acute appendicitis. Tokaij Exp Clin Med. 2003;28:39-44.
  • 17. Rettenbacher T, Hollerweger A, Macheiner P, Gritzmann N. Ultrasonography of the normal vermiform appendix. Ultraschall Med. 1997;18:139-42.
  • 18. Lee JH, Jeong YK, Hwang JC, Ham SY, Yang SO. Graded compression sonography with adjuvant use of a posterior manual compression technique in the sonographic diagnosis of acute appendicitis. AJR Am J Roentgenol. 2002;178:863-8.
  • 19. Lehmann D, Uebel P, Weiss H, Fiedler L, Bersch W. Sonographic representation of the normal and acute inflamed appendix--in patients with right-sided abdominal pain. Ultraschall Med. 2000;21:101-6.
  • 20. Rioux M. Sonographic detection of the normal and abnormal appendix. AJR Am J Roentgenol. 1992;158:773-8.
  • 21. Tarantino L, Giorgio A, de Stefano G, Scala V, Esposito F, et al. Acute appendicitis mimicking infectious enteritis: diagnostic value of sonography. J Ultrasound Med. 2003;22:945-50.
  • 22. Simonovsky V. Detection of acute appendicitis using ultrasonography. Rozhl Chir. 2000;79:215-20.
  • 23. Gough IR, Morris MI, Pertnikovs EI, Murray MR, Smith MB, et al. Consequences of removal of a "normal" appendix. Med J Aust. 1983;1:370-2.
  • 24. Walker SJ, West CR, Colmer MR. Acute appendicitis: does removal of a normal appendix matter, what is the value of diagnostic accuracy and is surgical delay important? Ann R Coll Surg Engl. 1995;77;358-63.
  • 25. Rioux M. Sonographic detection of the normal and abnormal appendix. AJR Am J Roentgenol. 1992;158:773-8.
  • 26. Zakaria O, Sultan TA, Khalil TH, Wahba T. Role of clinical judgment and tissue harmonic imaging ultrasonography in diagnosis of paediatric acute appendicitis. World J Emerg Surg. 2011;6:39.
  • 27. Rettenbacher T, Hollerweger A, Macheiner P, Rettenbacher L, Tomaselli F, et al. Outer diameter of the vermiform appendix as a sign of acute appendicitis: evaluation at US. Radiology. 2001;218:757-62.
  • 28. Menten R, Lebecque P, Saint-Martin C, Clapuyt P. Outer diameter of the vermiform appendix: not a valid sonographic criterion for acute appendicitis in patients with cystic fibrosis. AJR Am J Roentgenol. 2005;184:1901-3.
  • 29. Rettenbacher T, Hollerweger A, Macheiner P, Gritzmann N, Daniaux M, et al. Ovoid shape of the vermiform appendix: a criterion to exclude acute appendicitis--evaluation with US. Radiology. 2003;226:95-100.
  • 30. Wiersma F, Srámek A, Holscher HC. US features of the normal appendix and surrounding area in children. Radiology. 2005;235:1018-22.
  • 31. Yabunaka K, Katsuda T, Sanada S, Fukutomi T. Sonographic appearance of the normal appendix in adults. J Ultrasound Med. 2007;26:37-43.
  • 32. Jeffrey RB, Jain KA, Nghiem HV. Sonographic diagnosis of acute appendicitis: interpretive pitfalls. AJR Am J Roentgenol. 1994;162:55-9.
  • 33. Poljak A, Jeffrey RB Jr, Kernberg ME. The gas-containing appendix: potential sonographic pitfall in the diagnosis of acute appendicitis. J Ultrasound Med. 1991;10:625-8.
  • 34. Levine CD, Aizenstein O, Wachsberg RH. Pitfalls in the CT diagnosis of appendicitis. Br J Radiol. 2004;77:792-9.
There are 34 citations in total.

Details

Subjects Health Care Administration
Journal Section Original article
Authors

Mikail İnal

Birsen Ünal Daphan

M. Yasemin Karadeniz Bilgili

Publication Date December 31, 2016
Published in Issue Year 2016 Volume: 8 Issue: 4

Cite

Vancouver İnal M, Daphan BÜ, Bilgili MYK. Apendiksin ileal segmentlerden sonografik olarak ayırtedilebilmesi için gerekli kriterler: farklı bir bakış açısı. otd. 2016;8(4):200-6.

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