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英文誌(2004-)

Journal of Medical Ultrasonics

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1997 - Vol.24

Vol.24 No.04

Original Article(原著)

(0679 - 0685)

急性虫垂炎診断における超音波ハワードプラ法の有用性

Analysis of the Usefulness of Power Doppler Imaging in Diagnosing Acute Appendicitis

内田 浩也1, 奥野 敏隆2, 川崎 俊彦3, 前西 文秋1, 東 貞之1, 堀川 里紀1, 榊原 由希1, 登尾 薫1, 小森 英司3, 三村 純3, 井谷 智尚3, 仲瀬 裕志3

Hiroya UCHIDA1, Toshitaka OKUNO2, Toshihiko KAWASAKI3, Fumiaki MAENISHI1, Sadayuki AZUMA1, Riki HORIKAWA1, Yuki SAKAKIBARA1, Kaoru NOBORIO1, Hideshi KOMORI3, Jun MIMURA3, Toshinao ITANI3, Hiroshi NAKASE3

1西神戸医療センター臨床検査技術部, 2西神戸医療センター外科, 3西神戸医療センター内科

1Clinical Laboratory, Nishi-Kobe Medical Center, 2Department of Surgery, Nishi-Kobe Medical Center, 3Department of Internal Medicine, Nishi-Kobe Medical Center

キーワード : Appendicitis, Blood flow signals, Power Doppler, Ultrasonography

Although ultrasonography (US) has been used widely to diagnose acute appendicitis, it does not readily distinguish between normal and inflamed vermiform appendixes that are slightly enlarged (5 to 7 mm in maximal outer diameter). It is also difficult to determine severity of acute appendicitis when gray-scale US is used alone. Here we attempt to determine whether or not power Doppler US can be useful for determining severity of acute appendicitis. Sixteen patients with acute appendicitis and 10 patients with normal appendixes were evaluated with power Doppler US. One of the 16 patients with acute appendicitis had catarrhal appendicitis; 9, phlegmonous appendicitis; 4, gangrenous appendicitis; and 2, perforative appendicitis, and 9 of the 16 had blood-flow signals in the submucosal layer. One of the 9 with blood-flow signals in the submucosal layer had catarrhal appendicitis; 6, phlegmonous appendicitis; and 2, perforated appendicitis. Three of the remaining 7 patients, who had no blood-flow signals in the submucosal layer, had phlegmonous appendicitis, and 4 had gangrenous appendicitis. No blood-flow signals were found in the normal appendixes. We considered that blood-flow signals were present in the submucosal layer of patients with catarrhal and phlegmonous appendicitis but absent in patients with normal appendixes and those with gangrenous appendicitis. We thus conclude that combined use of power Doppler and gray-scale US enabled us to distinguish between catarrhal, phlegmonous, and gangrenous appendicitis. Power Doppler US can serve as a useful tool for determining grade of acute appendicitis.