The utility of acoustic radiation force impulse imaging in diagnosing acute appendicitis and staging its severity

• Published in: Diagnostic and interventional radiology (Ankara, Turkey) Vol. 20; no. 6; pp. 453 - 458
• Main Authors: Göya, Cemil, Hamidi, Cihad, Okur, Mehmet Hanifi, Içer, Mustafa, Oğuz, Abdullah, Hattapoğlu, Salih, Cetinçakmak, Mehmet Güli, Teke, Memik
• Format: Journal Article
• Language: English
• Published: Turkey Aves Yayincilik Ltd. STI 01.11.2014; Turkish Society of Radiology; Galenos Publishing House
• Subjects: Abdominal Imaging; Acute Disease; Adolescent; Adult; Aged; Appendicitis - diagnosis; Appendicitis - diagnostic imaging; Appendicitis - pathology; Child; Elasticity Imaging Techniques - methods; Female; Humans; Male; Middle Aged; Reproducibility of Results; ROC Curve; Sensitivity and Specificity; Young Adult
• ISSN: 1305-3825; 1305-3612
• DOI: 10.5152/dir.2014.13439

The aim of this study was to investigate the feasibility of using acoustic radiation force impulse (ARFI) imaging to diagnose acute appendicitis. Abdominal ultrasonography (US) and ARFI imaging were performed in 53 patients that presented with right lower quadrant pain, and the results were compared with those obtained in 52 healthy subjects. Qualitative evaluation of the patients was conducted by Virtual Touch™ tissue imaging (VTI), while quantitative evaluation was performed by Virtual Touch™ tissue quantification (VTQ) measuring the shear wave velocity (SWV). The severity of appendix inflammation was observed and rated using ARFI imaging in patients diagnosed with acute appendicitis. Alvarado scores were determined for all patients presenting with right lower quadrant pain. All patients diagnosed with appendicitis received appendectomies. The sensitivity and specificity of ARFI imaging relative to US was determined upon confirming the diagnosis of acute appendicitis via histopathological analysis. The Alvarado score had a sensitivity and specificity of 70.8% and 20%, respectively, in detecting acute appendicitis. Abdominal US had 83.3% sensitivity and 80% specificity, while ARFI imaging had 100% sensitivity and 98% specificity, in diagnosing acute appendicitis. The median SWV value was 1.11 m/s (range, 0.6-1.56 m/s) for healthy appendix and 3.07 m/s (range, 1.37-4.78 m/s) for acute appendicitis. ARFI imaging may be useful in guiding the clinical management of acute appendicitis, by helping its diagnosis and determining the severity of appendix inflammation.