Value of ultrasonography in the diagnosis of acute appendicitis

During a 12-month period high-resolution, real-time uitrasonography (US) with graded compression was performed on 268 consecutive patients with clinically suspected acute appendicitis and its complications.US visualization of a fluid-filled , non-compressed appendix or a decompressed, thick-walled appendix was the prima까 criterion for a diagnosis of acute appendicitis.The sonographic findings were correlated with surgical-pathologic outcome in 92 cases and with the findings of clinical follow-ups in the remainder.US was found to be accurate in the diagnosis of acute appen이 citis and its complication with a sensitivity of 93.3%, a specificity of 98.9%, and an accuracy of 97%.The predictiv~ value of a positive test was 97.7%; that of a negative test was 96.7%.There were two false-positive examinations in patients with a thick-walled appendix or periapperdiceal abscess, which were surgically confirmed as appendiceal adenocarcinoma and perforated cecal diverticulitis respectively.There were six false-negative examÏnations in patients with a sonographically no-visible appendix, which were confirmed surgically as acute appendicitis (n=5) and perforated appen며citis (n= 1).Our results show that high-resolution, real-time US is an accureate imaging modality in the diagnosis of acute appendicitis and the evaluation of its complications.