R. Associated intra- abdomin,. Disease Yes No No Yes Investigations Laboratory AP26113 nmr – High WBCs – Elevated CRP Yes Yes No No – Urine analysis (Findings of UTI) No Yes Tissue Harmonic U.S. RLQ -Aperistaltic non- Compressible blind ended tubular structure Yes No -Distinct thickened appendicial wall layers Yes No – Outer diameter > 6 mm Yes No -Target sign appearance Yes No -Appendicolith(s) Yes No -Periappendiceal fluid collection Yes No – Echogenic Prominent pericecal fat Appendicolith Yes No – +ve findings in female Adnxae No Yes Total
score Interpretation of results: 15 – 25 = highly suggestive of appendicitis. 8 – 14 = Patient needs repeated evaluation for conclusive result. 0 – 7 = the diagnosis of acute appendicitis in not likely. Ultrasonography was performed using linear and CH5424802 purchase curved transducers with ultrasound frequencies ranged between 2.5 and 7.5 MHz, commercially available ultrasound systems (Siemens Sonoline Elegra, Germany). The examination
was performed with both conventional and THI- US. Scanning parameters were optimized for each method, and all images were obtained with use of the same focal zone. A cine playback mode was used to obtain identical images in two standard planes, longitudinal and transverse scans. Images were obtained with the two methods in random sequence to facilitate their masking for the observers. Harmonic images Gamma-secretase inhibitor were acquired at a transmitting frequency of 2.0 MHz and a receiving harmonic bandwidth of 4.0 MHz. Conventional US images were obtained at a frequency of 3.5 MHz, which is the commonly used frequency at abdominal imaging in adults. The harmonic and conventional US modes were switched by means of a toggle switch on the scanner control panel. In both the previous CPGS and the current MCPGS rationale of active watchful waiting in suspected appendicitis was Immune system a prudent and safe strategy with the use of at least one time repetition
of conventional US or THI- US with no increase in the risk of perforation (Figures 1,2,3). All appendices were routinely sent for histopathological examination. Figure 1 Acute appendicitis by conventional US in a longitudinal scan using linear transducer with 7.5 MHz frequency showing a thick walled blind ended apristaltic non compressible inflamed appendix.. Figure 2 Acute appendicitis by tissue harmonic imaging sonography (THI) using linear transducer with 7.5 MHz revealed: A. Longitudinal scan showing aperistaltic non compressible blind ended tubular structure with distinct thickened wall layers and diameter > 6 mm. B. Transverse scan showing target sign appearance. Figure 3 Acute appendicitis by tissue harmonic imaging sonography (THI) using linear transducer with 7.5 MHz revealed: A.