DIAGNOSTIC ACCURACY OF TISSUE HARMONIC IMAGING IN DETECTION OF APPENDICITIS BY TAKING HISTOPATHOLOGY AS GOLD STANDARD-EXPERIENCE AT TERTIARY CARE HOSPITAL

Talhya Yaseen; Ameet Kumar Jesrani; Sehrish Mahreen; Rizwan Ajmal

DIAGNOSTIC ACCURACY OF TISSUE HARMONIC IMAGING IN DETECTION OF APPENDICITIS BY TAKING HISTOPATHOLOGY AS GOLD STANDARD-EXPERIENCE AT TERTIARY CARE HOSPITAL

Talhya Yaseen, Ameet Kumar Jesrani, Sehrish Mahreen, Rizwan Ajmal

Abstract

Objective: To determine the diagnostic accuracy of tissue harmonic imaging in detection of appendicitis by taking histopathology as gold standard.

Design: Cross sectional study

Patients and Methods: There were 378 patients with sign and symptoms of appendicitis patients were included in this study. Ultrasonography was performed, using linear and curved transducers with ultrasound frequencies ranged between 2.5 and 7.5 MHz, commercially available ultrasound systems. The examination was performed with both Conventional and Tissue Harmonic Image. Specimen for the confirmation of appendicitis was taken during surgery and sent to Histopathology Lab. All the information was recorded into predesigned proforma.

Results: Sensitivity, specificity, PPV, NPV and accuracy of tissue harmonic imaging in detection of appendicitis was 81.18%, 86.88%, 42.86%, 97.44% and 86.26% respectively.

Conclusion: We conclude that tissue harmonic imaging better visualizes the appendix and should be the preferred modality for scanning the right lower abdomen in cases of suspected acute appendicitis.

Keywords: Acute appendicitis, Harmonic imaging, Ultrasound modality

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References

REFERENCES:

Rompel O, Huelsse B, Bodenschatz K, Reutter G, Darge K. Harmonic US imaging of appendicitis in children. Pediatr Radiol. 2006;36:1257–64.

Fonio P, Coppolino F, Russo A, Andrea AD, Giannattasio A, Reginelli A, et al. Ultrasonography (US) in the assessment of pediatric non traumatic gastrointestinal emergencies. Crit Ultrasound J. 2013;5(Suppl 1):12.

Parks NA, Schroeppel TJ. Update on imaging for acute appendicitis. Surg Clin North Am. 2011 Feb;91(1):141-54.

Zakaria O, Sultan TA, Khalil TH, Wahba T. Role of clinical judgment and tissue harmonic imaging ultrasonography in diagnosis of paediatric acute appendicitis. World J Emerg Surg. 2011;6:39.

Oktar SO, Yücel C, Özdemir H, Ulutürk A, Işık S. Comparison of conventional sonography, real-time compound sonography, tissue harmonic sonography, and tissue harmonic compound sonography of abdominal and pelvic lesions. Am J Radiol. 2003;181:1341-7.

Dumitriu D, Galloy MG, Claudon M. New techniques in pediatric ultrasound. Ultrasound Clin. 2010;(5):153-69.

Qazi AS. Sonographic accuracy in determining acute appendicitis in the children in a tertiary care hospital. Ann King Edward Med Coll. 2008;14(4):133-7.

Arooj S, Mansoor M, Amir I. Ultrasound for the diagnosis of acute appendicitis: a hospital based study. Pak J Med Health Sci. 2013;7(4):59.

Zakaria OM, Adly OA, El-Labban GA, Khalil HT. Acute appendicitis in children: a clinical practice guideline scoring system. Suez Canal Univ Med J. 2005;8:20-6.

Samuel M. Pediatric appendicitis score. J Pediatr Surg. 2002;37:877-81.

Liu CD, McFadden DW. Acute abdomen and appendix. In: Greenfield LJ, editors. Surgery: scientific c principles and practice. Philadelphia: Lippincott-Raven; 1997. P. 1246-61.

Addiss DG, Shaffer N, Fowler BS. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol. 1990;132:910-25.

Telford GL, Condon RE. Apendix. In: Zuidema GD, Surgery of the alimentary tract. Philadelphia: Saunders; 1991. P. 133-41.

Flum DR, Koepsell T. The clinical and economic correlates ofmisdiagnosed appendicitis: Nationwide analysis. Arch Surg 2002;137:799-804.

Putnam TC, Gagliano N, Emmens RW. Appendicitis in children. Surg Gynecol Obstet. 1990;170:527-32.

Blab E, Kohlhuber U, Tillawi S. Advancements in the diagnosis of acute appendicitis in children and adolescents. Eur J Pediatr Surg. 2004;14:404–9.

Schwartz SI. Appendix. In: Schwartz SI, editor. Principles of surgery. New York: McGraw Hill; 1994. P. 1307-18.

Puig S, Hormann M, Rebhandl W, Felder-Puig RF, Prokop M, Paya K. US as a primary diagnostic tool in relation to negative appendectomy: six years experience. Radiology. 2003;226:101–4.

Rao PM, Rhea JT, Novelline RA. Helical CT technique for the diagnosis of appendicitis: prospective evaluation of a focused appendix CT examination. Radiology. 1997;202:139.

Orr RK, Porter D, Hartman D. Ultrasonography to evaluate adults for appendicitis: decision making based on metaanalysis and probabilistic reasoning. Acad Emerg Med. 1995;2:644-50.

Rao PM, Feltmate CM, Rhea JT, Schulick AH, Novelline RA. Helical computed tomography in differentiating appendicitisand acute gynecologic conditions. Obstet Gynecol. 1999;93:417-21.

Gaensler EH, Jeffrey RB Jr, Laing FC, Townsend RR. Sonography in patients with suspected acute appendicitis: value in establishing alternative diagnoses. AJR Am J Roentgenol. 1989;152:49-51.

Hagendorf BA, Clarke JR, Burd RS. The optimal initial management of children with suspected appendicitis: a decision analysis. J Pediatr Surg. 2004;39:880–5.

Shapiro RS, Wagreish J, Parsons RB, Stancato-Pasik A, Yeh HC, Lao R. Tissue harmonic imaging sonography: evaluation of image quality compared with conventional sonography. AJR. 1998;171:1203-6.

Hann LE, Bach AM, Cramer LD, Siegel D, Yoo HH, Garcia R. Hepatic sonography: comparison of tissue harmonic and standard sonography techniques. AJR Am J Roentgenol. 1999;173(1):201–6.

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