[Diagnosis of appendicitis using harmonic ultrasound imaging].
BACKGROUND
Harmonic Imaging (HI) is a new Ultrasound (US) modality with high contrast and spatial resolution. Aim of this study was to compare fundamental imaging (FI) and HI in the diagnosis of appendicitis.


METHODS
In 50 children (male : female, 25 : 25; mean age: 9.9 years) prior to an appendectomy US of the right lower quadrant was performed in both FI and HI (Tissue Harmonic Imaging - THI - Sonoline Elegra, Siemens, 7.5 MHz linear). The images were compared with respect to delineation of surrounding, contour, wall and content of the appendix.


RESULTS
In 43 / 50 (86 %) patients diagnosis of appendicitis was confirmed histologically (sensitivity 98 %, specificity 94 %). In 37 / 43 patients the appendix was depicted using FI. With HI this number was 40 / 43. HI was significantly better in delineating the contour, wall, mucosa and content of the appendix (p < 0.01). HI also exceeded in demonstrating free fluid, mesenterial lymph nodes and surrounding echogenicity.


CONCLUSIONS
HI of appendicitis provides images with significantly better quality than FI. When both imaging options are available harmonic imaging modality should be the preferred choice for scanning the appendix.
Hülsse
B
B
Klinik für Kinderchirurgie, Klinikum Nürnberg Süd. bhuelsse@hotmail.com
Rompel
O
O
Bodenschatz
K
K
Leriche
C
C
Bär
I
I
Darge
K
K
D000293:Adolescent; D001062:Appendectomy; D001064:Appendicitis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D001065:Appendix / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*