Gu FW, Wu SZ. Added value of ratio of cross diameters of the appendix in ultrasound diagnosis of acute appendicitis. World J Gastrointest Surg 2024; 16(1): 21-28 [PMID: 38328334 DOI: 10.4240/wjgs.v16.i1.21]
Corresponding Author of This Article
Si-Ze Wu, MD, Chief Doctor, Professor, Department of Ultrasound, The First Affiliated Hospital of Hainan Medical University, No. 31 Longhua Road, Haikou 570102, Hainan Province, China. wsz074@aliyun.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jan 27, 2024; 16(1): 21-28 Published online Jan 27, 2024. doi: 10.4240/wjgs.v16.i1.21
Added value of ratio of cross diameters of the appendix in ultrasound diagnosis of acute appendicitis
Feng-Wa Gu, Si-Ze Wu
Feng-Wa Gu, Si-Ze Wu, Department of Ultrasound, The First Affiliated Hospital of Hainan Medical University, Haikou 570102, Hainan Province, China
Author contributions: Gu FW participated in the study design, obtained the materials, analyzed the data, and wrote the first manuscript; Wu SZ participated in the study design, data obtaining and analysis, and wrote and revised the manuscript; all authors read and approved the final manuscript.
Institutional review board statement: The study was approved by the ethics committee of First Affiliated Hospital of Hainan Medical University.
Informed consent statement: No informed consent was required, because the data are anonymized.
Conflict-of-interest statement: No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at wsz074@aliyun.com.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Si-Ze Wu, MD, Chief Doctor, Professor, Department of Ultrasound, The First Affiliated Hospital of Hainan Medical University, No. 31 Longhua Road, Haikou 570102, Hainan Province, China. wsz074@aliyun.com
Received: October 2, 2023 Peer-review started: October 2, 2023 First decision: December 6, 2023 Revised: December 13, 2023 Accepted: December 28, 2023 Article in press: December 28, 2023 Published online: January 27, 2024 Processing time: 114 Days and 16.3 Hours
ARTICLE HIGHLIGHTS
Research background
Ultrasound (US) is commonly used for diagnosing acute appendicitis, but the diagnostic performance remains for further improvement. The size of the appendix is crucial for distinguishing between a normal appendix and acute appendicitis.
Research motivation
The maximal outside diameter on the cross section of the appendix > 6 mm has been recommended as a cut-off value for diagnosing acute appendicitis, but the minimal outside diameter and the ratio of the two outside diameters have not been adequately studied.
Research objectives
To investigate if the ratio of the two outside diameters on the cross section of the appendix is a useful parameter for diagnosing acute appendicitis.
Research methods
The investigators measured the two outside diameters on the cross section of a normal appendix and acute appendicitis without perforation using ultrasonography and calculated their ratio. The diagnostic performance of the maximal outside diameter, the ratio of two diameters on the cross section of the appendix, and their combination were compared.
Research results
A ratio of the diameter on the cross section of the appendix ≤ 1.18 was identified as a cut-off value for predicting acute appendicitis. The diagnostic performance based on the ratio of two diameters on the cross section of the appendix ≤ 1.18 was significantly higher than that of the maximal outside diameter.
Research conclusions
Combining the maximal outside diameter and the ratio of two diameters on the cross section of the appendix improved diagnostic performance compared to using the maximal outside diameter alone.
Research perspectives
Further prospective studies are needed to validate the findings and the use of a combination of the maximal outside diameter and the ratio of two diameters for US diagnosis of acute appendicitis.
