Abstract
Purpose : To determine whether addition of power Doppler ultrasonography (US) to grayscale US is useful in evaluating appendicitis in children. Methods : In a retrospective study, grayscale US findings were evaluated in 100 children. Power Doppler US was also done in 15 children. Criterion for appendicitis was a diameter of the appendix exceeding 6mm. Ultrasonographic findings of acute appendicitis were classified into 3 grades based on the appearance of intramural appendiceal structure (grade I : clear wall structure, grade II : unclear wall structure, grade III : loss of wall structure). Findings of power Doppler US were also classified into 4 grades (none, low, moderate, and high blood flow). Results : In grayscale US, 15 children were grade I. Sixty-six children were grade II and 19 were grade III. Appendectomy was performed in 73 cases. In all operated cases, pathological diagnosis was appendicitis including 2 (2.7%) catarrhal appendicitis. All grade I cases were conservatively treated. In grade II, 12 cases were treated conservatively and 54 cases were operated on. All 19 cases in grade III were operated on. In 15 cases which were examined by power Doppler US, 8 cases were treated conservatively. Five of them in grade I of grayscale US showed low blood flow and 3 cases in grade II showed high blood flow. In the remaining 7 cases who underwent surgery, none of them showed high blood flow. Conclusions : Addition of power Doppler US to conventional grayscale US improved the accuracy in determining the surgical indication of acute appendicitis.
