Appendicitis: usefulness of color Doppler US.
OBJECTIVE
To assess whether color Doppler ultrasonography (US) can help diagnose early acute appendicitis in appendices of equivocal size at gray-scale US.


METHODS
In a retrospective study, color Doppler US findings were evaluated in 20 individuals with proved normal appendix at barium enema examination and in 50 patients in whom pathologic findings confirmed acute appendicitis. In a prospective study, the diagnostic value of hyperemia in the wall of the appendix in differentiating a normal from an inflamed appendix was evaluated in 26 patients with appendices of equivocal size (5-7 mm in maximal outer diameter) at grayscale US.


RESULTS
In the retrospective study, 44 of the 50 patients had hyperemia at color Doppler US. The remaining six patients had no hyperemia, and pathologic findings confirmed gangrenous appendices. The 20 patients with proved normal appendix at barium enema examination had no detectable blood flow in the wall. In the prospective study, 10 of 26 patients had hyperemia at color Doppler US, and pathologic findings confirmed early acute appendicitis. Results of barium enema examination (n = 12) or clinical follow-up (n = 4) confirmed no appendicitis in the remaining 16 patients.


CONCLUSIONS
Hyperemia in the wall of the appendix at color Doppler US is a sensitive indicator for inflammation. A simple additional color Doppler US examination may be helpful in the diagnosis of early acute appendicitis when an appendix is well depicted and is equivocal in size at gray-scale US.
Lim
H K
HK
Department of Radiology, Samsung Medical Center, Seoul, Korea.
Lee
W J
WJ
Kim
T H
TH
Namgung
S
S
Lee
S J
SJ
Lim
J H
JH
D000208:Acute Disease; D000328:Adult; D001064:Appendicitis / Q000000981:diagnostic imaging*; D001065:Appendix / Q000098:blood supply / Q000000981:diagnostic imaging; D001466:Barium Sulfate; D016022:Case-Control Studies; D003287:Contrast Media; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color
D003287:Contrast Media; D001466:Barium Sulfate