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Emergency Radiology

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24-01-2024 | Appendicitis | Original Article

Diagnostic performance of spectral Doppler in acute appendicitis with an equivocal Alvarado score

Authors: Reham Abd El-Aleem, Abdelrahman A. Abd Allah, Mahmoud Refaat Shehata, Gehan S. Seifeldein, Sara M. Hassanein

Published in: Emergency Radiology | Issue 2/2024

Abstract

Purpose

This study aims to evaluate the added value of duplex Doppler examination to the routinely graded compression grayscale ultrasound (US) for patients with suspected acute appendicitis (AA) in correlation with surgical management outcomes.

Methods

The study lasted from January 2020 to March 2021. Throughout that period, patients who had suspected appendicitis were included with a visible appendix in the grayscale US. These patients were categorized clinically based on Alvarado’s score. They underwent graded compression grayscale US of the appendix and duplex Doppler study. Subsequently, they were assigned for non-contrast multislice computed tomography (MSCT) according to Alvarado’s score and underwent either emergency appendicectomy or conservative clinical management afterward. A Student’s t-test was used to determine if there were significant differences in the mean values between the groups. The diagnostic performance of spectral Doppler US for the diagnosis of AA was depicted.

Results

Eighty-four patients with visualized color flow in the appendicular Doppler US were enrolled, with 60 (71.4%) having AA, and 24 (28.6%) not having appendicitis. Spectral Doppler criterion of PSV greater than 8.6 cm/s demonstrated a high sensitivity of 91.67% and specificity of 77.78% for patients with Alvarado score ranging from 4 to 7, and appendiceal MOD ranging from 6 to 8 mm, while a discriminatory criterion of RI greater than 0.51 had a high sensitivity of 100% and a relatively lower specificity of 66.67%.

Conclusion

The patients with AA have significantly higher point PSV and point RI values than those without AA and are especially useful in equivocal patients whose MODs and Alvarado scores are in the diagnostically equivocal ranges of 6–8 mm and 4–7, respectively, with the point PSV and RI demonstrating negative predictive value 87.5% and 100%.

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Title: Diagnostic performance of spectral Doppler in acute appendicitis with an equivocal Alvarado score
Authors: Reham Abd El-Aleem
Abdelrahman A. Abd Allah
Mahmoud Refaat Shehata
Gehan S. Seifeldein
Sara M. Hassanein
Publication date: 24-01-2024
Publisher: Springer International Publishing
Keywords: Appendicitis
Appendicitis
Computed Tomography
Computed Tomography
Published in: Emergency Radiology / Issue 2/2024
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI: https://doi.org/10.1007/s10140-024-02205-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Diagnostic performance of spectral Doppler in acute appendicitis with an equivocal Alvarado score

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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