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.
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。