{Reference Type}: Journal Article
{Title}: Added value of ratio of cross diameters of the appendix in ultrasound diagnosis of acute appendicitis.
{Author}: Gu FW;Wu SZ;
{Journal}: World J Gastrointest Surg
{Volume}: 16
{Issue}: 1
{Year}: 2024 Jan 27
暂无{DOI}: 10.4240/wjgs.v16.i1.21
{Abstract}: <B>BACKGROUND: </B>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.<BR><B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.