title: The utility of acoustic radiation force impulse imaging in diagnosing acute appendicitis and staging its severity.
abstract: OBJECTIVE
  The aim of this study was to investigate the feasibility of using acoustic radiation force impulse (ARFI) imaging to diagnose acute appendicitis.
  
  
  METHODS
  Abdominal ultrasonography (US) and ARFI imaging were performed in 53 patients that presented with right lower quadrant pain, and the results were compared with those obtained in 52 healthy subjects. Qualitative evaluation of the patients was conducted by Virtual Touch™ tissue imaging (VTI), while quantitative evaluation was performed by Virtual Touch™ tissue quantification (VTQ) measuring the shear wave velocity (SWV). The severity of appendix inflammation was observed and rated using ARFI imaging in patients diagnosed with acute appendicitis. Alvarado scores were determined for all patients presenting with right lower quadrant pain. All patients diagnosed with appendicitis received appendectomies. The sensitivity and specificity of ARFI imaging relative to US was determined upon confirming the diagnosis of acute appendicitis via histopathological analysis.
  
  
  RESULTS
  The Alvarado score had a sensitivity and specificity of 70.8% and 20%, respectively, in detecting acute appendicitis. Abdominal US had 83.3% sensitivity and 80% specificity, while ARFI imaging had 100% sensitivity and 98% specificity, in diagnosing acute appendicitis. The median SWV value was 1.11 m/s (range, 0.6-1.56 m/s) for healthy appendix and 3.07 m/s (range, 1.37-4.78 m/s) for acute appendicitis.
  
  
  CONCLUSIONS
  ARFI imaging may be useful in guiding the clinical management of acute appendicitis, by helping its diagnosis and determining the severity of appendix inflammation.
authors.affiliation: Department of Radiology, Dicle University School of Medicine, Diyarbakır, Turkey. cegoya1@yahoo.com.
authors.forename: Cemil
authors.initials: C
authors.lastname: Göya
authors.forename: Cihad
authors.initials: C
authors.lastname: Hamidi
authors.forename: Mehmet Hanifi
authors.initials: MH
authors.lastname: Okur
authors.forename: Mustafa
authors.initials: M
authors.lastname: Içer
authors.forename: Abdullah
authors.initials: A
authors.lastname: Oğuz
authors.forename: Salih
authors.initials: S
authors.lastname: Hattapoğlu
authors.forename: Mehmet Güli
authors.initials: MG
authors.lastname: Cetinçakmak
authors.forename: Memik
authors.initials: M
authors.lastname: Teke
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001064:Appendicitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult