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Abstract：
BACKGROUND: The maximum outer diameter (MOD) of the appendix is an essential parameter for diagnosing acute appendicitis, but there is space for improvement in ultrasound (US) diagnostic performance.
OBJECTIVE: To investigate whether combining the ratio of the cross diameters (RATIO) of the appendix with MOD of the appendix can enhance the diagnostic performance of acute appendicitis.
METHODS: A retrospective study was conducted, and medical records of 233 patients with acute appendicitis and 112 patients with a normal appendix were reviewed. The MOD and RATIO of the appendix were calculated and tested for their diagnostic performance of acute appendicitis, both individually and in combination.
RESULTS: The RATIO for a normal appendix was 1.32 ± 0.16, while for acute appendicitis it was 1.09 ± 0.07. The cut-off value for RATIO was determined to be ≤ 1.18. The area under the receiver operating characteristic curve (AUC) for diagnosing acute appendicitis using RATIO ≤ 1.18 and MOD > 6 mm was 0.870 and 0.652, respectively. There was a significant difference in AUC between RATIO ≤ 1.18 and MOD > 6 mm (P < 0.0001). When comparing the combination of RATIO ≤ 1.18 and MOD > 6 mm with MOD > 6 mm alone, the combination showed increased specificity, positive predictive value (PPV), and AUC. However, the sensitivity and negative predictive value decreased.
CONCLUSIONS: Combining RATIO of the appendix ≤ 1.18 and MOD > 6 mm can significantly improve the specificity, PPV, and AUC in the US diagnosis of acute appendicitis.
OBJECTIVE: To investigate whether combining the ratio of the cross diameters (RATIO) of the appendix with MOD of the appendix can enhance the diagnostic performance of acute appendicitis.
METHODS: A retrospective study was conducted, and medical records of 233 patients with acute appendicitis and 112 patients with a normal appendix were reviewed. The MOD and RATIO of the appendix were calculated and tested for their diagnostic performance of acute appendicitis, both individually and in combination.
RESULTS: The RATIO for a normal appendix was 1.32 ± 0.16, while for acute appendicitis it was 1.09 ± 0.07. The cut-off value for RATIO was determined to be ≤ 1.18. The area under the receiver operating characteristic curve (AUC) for diagnosing acute appendicitis using RATIO ≤ 1.18 and MOD > 6 mm was 0.870 and 0.652, respectively. There was a significant difference in AUC between RATIO ≤ 1.18 and MOD > 6 mm (P < 0.0001). When comparing the combination of RATIO ≤ 1.18 and MOD > 6 mm with MOD > 6 mm alone, the combination showed increased specificity, positive predictive value (PPV), and AUC. However, the sensitivity and negative predictive value decreased.
CONCLUSIONS: Combining RATIO of the appendix ≤ 1.18 and MOD > 6 mm can significantly improve the specificity, PPV, and AUC in the US diagnosis of acute appendicitis.
摘要：
背景：阑尾的最大外径（MOD）是诊断急性阑尾炎的必要参数，但超声（US）诊断性能仍有改进的空间。
目的：研究将阑尾的横径比（RATIO）与阑尾的MOD相结合是否可以提高急性阑尾炎的诊断性能。
方法：进行了回顾性研究，回顾了233例急性阑尾炎患者和112例正常阑尾患者的病历。计算和测试了附录的MOD和RATIO对急性阑尾炎的诊断性能，无论是单独还是组合。
结果：正常阑尾的比率为1.32±0.16，而急性阑尾炎的比率为1.09±0.07。RATIO的截止值确定为≤1.18。使用RATIO≤1.18和MOD>6mm诊断急性阑尾炎的受试者工作特征曲线下面积（AUC）分别为0.870和0.652。RATIO≤1.18和MOD>6mm之间的AUC差异有统计学意义（P<0.0001）。当RATIO≤1.18和MOD>6mm的组合与MOD>6mm单独比较时,组合显示出增加的特异性，阳性预测值(PPV)，AUC。然而,敏感性和阴性预测值下降。
结论：结合附录的比值≤1.18和MOD>6mm可以显著提高特异性，PPV,和AUC在美国诊断为急性阑尾炎。
目的：研究将阑尾的横径比（RATIO）与阑尾的MOD相结合是否可以提高急性阑尾炎的诊断性能。
方法：进行了回顾性研究，回顾了233例急性阑尾炎患者和112例正常阑尾患者的病历。计算和测试了附录的MOD和RATIO对急性阑尾炎的诊断性能，无论是单独还是组合。
结果：正常阑尾的比率为1.32±0.16，而急性阑尾炎的比率为1.09±0.07。RATIO的截止值确定为≤1.18。使用RATIO≤1.18和MOD>6mm诊断急性阑尾炎的受试者工作特征曲线下面积（AUC）分别为0.870和0.652。RATIO≤1.18和MOD>6mm之间的AUC差异有统计学意义（P<0.0001）。当RATIO≤1.18和MOD>6mm的组合与MOD>6mm单独比较时,组合显示出增加的特异性，阳性预测值(PPV)，AUC。然而,敏感性和阴性预测值下降。
结论：结合附录的比值≤1.18和MOD>6mm可以显著提高特异性，PPV,和AUC在美国诊断为急性阑尾炎。
