Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2025
Diagnostic Ability of Transabdominal Ultrasonography for Appendiceal Diverticulitis.
СтатьяНазвание и аннотация: Перевод в очереди
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Sato Aya, Kojima Yuki, Nakamura Shiori, Maeoka Etsuko, Nisaka Yoshimi, Gunji Masaharu, Takamizawa Junichi, Fujino Masahiko, Yuasa Norihiro
Аннотация
OBJECTIVES: Appendiceal diverticulitis (AD) is frequently confused with acute appendicitis (AA); however, AD carries a higher risk of perforation and malignancy than AA. We aimed to evaluate the preoperative diagnostic ability of transabdominal ultrasonography (US) for AD.
METHODS: We included 74 patients who underwent appendectomy with a preoperative diagnosis of AA, AD, and US within a day of surgery. AD was diagnosed using US by identifying protruding, pouch-like hypoechoic structures beyond the appendiceal margin, whereas it was diagnosed using histopathology by identifying the invagination of the appendiceal epithelium into the muscularis propria.
RESULTS: The median patient age was 45 years (61% males). Among the patients with a US diagnosis of AD, 9 patients had histopathological AD, while one patient did not. The other 64 patients without a US diagnosis of AD did not have histopathological AD. US showed 100% sensitivity, 98% specificity, 90% positive predictive value, 100% negative predictive value, and 99% accuracy for AD. A retrospective review of US images showed that 8 patients exhibited high echoic rims at the border of the hypoechoic structures among the 9 patients with histopathological AD. When this finding was incorporated into the US diagnosis of AD, the specificity increased to 100%.
CONCLUSIONS: The diagnostic accuracy of US for AD is high. Not only are protruding pouch-like hypoechoic structures specific for the US diagnosis of AD, but also highly echoic rims at the border.
METHODS: We included 74 patients who underwent appendectomy with a preoperative diagnosis of AA, AD, and US within a day of surgery. AD was diagnosed using US by identifying protruding, pouch-like hypoechoic structures beyond the appendiceal margin, whereas it was diagnosed using histopathology by identifying the invagination of the appendiceal epithelium into the muscularis propria.
RESULTS: The median patient age was 45 years (61% males). Among the patients with a US diagnosis of AD, 9 patients had histopathological AD, while one patient did not. The other 64 patients without a US diagnosis of AD did not have histopathological AD. US showed 100% sensitivity, 98% specificity, 90% positive predictive value, 100% negative predictive value, and 99% accuracy for AD. A retrospective review of US images showed that 8 patients exhibited high echoic rims at the border of the hypoechoic structures among the 9 patients with histopathological AD. When this finding was incorporated into the US diagnosis of AD, the specificity increased to 100%.
CONCLUSIONS: The diagnostic accuracy of US for AD is high. Not only are protruding pouch-like hypoechoic structures specific for the US diagnosis of AD, but also highly echoic rims at the border.