Appendicitis: Evaluation of Sensitivity, Specificity, and Predictive Values of US, Doppler US, and Laboratory Findings

PURPOSE: To evaluate the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of ultrasonography (US), Doppler US, and laboratory findings in the diagnosis of appendicitis. MATERIALS AND METHODS: A total of 125 consecutive patients suspected of having appendicitis were prospectively included for US appendiceal (diameter enlarged to 6 mm or greater, intraluminal fluid, lack of compressibility) and periappendiceal (periileal inflammatory changes, cecal wall thickening, periileal lymph nodes, peritoneal fluid) evaluation, Doppler US evaluation (appendiceal wall signal), and laboratory assessment (leukocytosis, C-reactive protein [CRP]). Definite diagnoses were established at surgery in 61 patients, at endoscopy with biopsy in two patients, and at clinical follow-up in 62 patients. RESULTS: The prevalence of appendicitis was 46%. The appendix was identified with US in 86% of the patients, which included 96% of patients with and 72% of patients without appendicitis. Th...