J Korean Soc Ultrasound Med.  2007 Sep;26(3):145-153.

High-Resolution Ultrasonography (US) of Appendiceal Specimens: Differentiation of Acute Non-perforated Appendicitis from Perforated Appendicitis

• Choi GC
• Kim S
• Im HH
• Lee SJ
• Yang SB
• Lee SW
• Lee HK
• Kwon KH
• Shin HC
• Kim IY

Abstract

PURPOSE: To analyze surgical specimens from patients with acute non-perforated and perforated appendicitis using high-resolution ultrasonography (US), and to correlate the US features with the pathologic findings.
MATERIALS and METHODS
One hundred and six surgical appendix specimens obtained from patients with suspected acute appendicitis were evaluated. The following US features were evaluated for differentiating acute non-perforated appendicitis from perforated appendicitis: circumferential loss of the echogenic submucosal layer, disruption of the serosal layer, asymmetrical wall thickening, the sum of opposing walls > or = 9 mm and the presence of appendicoliths. The sensitivity and specificity of the US findings for diagnosing perforated appendicitis were determined.
RESULTS
All US features were detected significantly more often in the perforated appendicitis group of specimens. The disruption of the serosal layer was the most significant independent predictor of perforation (p < .001). The sensitivity for circumferential loss of the echogenic submucosal layer, disruption of the serosal layer, asymmetrical wall thickening, wall thickness > or = 9 mm, and the presence of appendicoliths individually was 84.6%, 69.2%, 61.5%, 73.1% and 46.2%, respectively. The specificity for all of these findings was 86.3%, 98.7%, 95.0%, 85.0% and 85.0%, respectively.
CONCLUSION
High-resolution US of appendiceal specimens was very useful for differentiating acute non-perforated from perforated appendicitis.

Keyword

Appendicitis; Appendix; Appendix, US; Ultrasound(US)

MeSH Terms

Appendicitis*
Appendix
Humans
Sensitivity and Specificity
Ultrasonography*