Abstract
ABSTRACT:
 BACKGROUND: A common surgical emergency is acute appendicitis. Various diagnostic tools are available to diagnosis acute appendicitis. Radiological investigations play an important role in making accurate and early diagnosis and thus preventing morbidity associated with the disease.
 OBJECTIVE: To determine the diagnostic accuracy of gray scale ultrasonography versus color Doppler in suspected cases of acute appendicitis.
 MATERIALS AND METHODS: The study was carried in the department of Radiology of Mayo Hospital, Lahore. A total of 75 patients were enrolled of age 18-40 years, both genders who were suspected cases of acute appendicitis. All patients underwent baseline investigations along with gray scale ultrasonography and color Doppler. All patients were subjected to surgery to confirm the diagnosis and findings were subjected to statistical analysis.
 RESULTS: The mean age of the patients was 23.25 ±10.55 and mean transverse diameter of appendix was 8.37 ±3.39. There were 62.7% males and 37.3%females. Findings of gray scale ultrasonography and color Doppler were then correlated with surgical findings to calculate the diagnostic accuracy of these modalities. The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively. Diagnostic accuracy of both modalities together was 98.6%.
 CONCLUSION: Color Doppler has better diagnostic accuracy than gray scale ultrasonography for diagnosis of acute appendicitis and the combination of both modalities yields diagnostic accuracy that is similar to gold standard.
Highlights
Among surgical problems that are of acute nature, the commonest one is acute appendicitis (1)
Findings of gray scale ultrasonography and color Doppler were correlated with surgical findings to calculate the diagnostic accuracy of these modalities
The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively
Summary
Among surgical problems that are of acute nature, the commonest one is acute appendicitis (1). The purpose of current study was to assess the diagnostic accuracy of graded compression ultrasonography and color Doppler in suspected patients of acute appendicitis keeping surgical notes (operative findings) as gold standard. Quantitative measures such as age, transverse diameter were presented as mean and standard deviation Qualitative variables such as gender, presenting symptoms (nausea, vomiting, rebound tenderness, anorexia, fever), visualization of appendix, transverse diameter, compressibility, abnormal appendiceal wall signature, appendicolith, echogenic surrounding mesentery, free fluid presence, mesenteric lymph nodes involvement, hyperemia and its type, ultrasound findings, color Doppler findings and findings of surgical intervention were presented as frequency and percentages. 2*2 table was made to determine the diagnostic accuracy of gray scale ultrasonography and color Doppler in diagnosing acute appendicitis keeping surgical intervention findings as gold standard.
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