EMERGENCY BASED ULTRASOUND OF CLINICALLY SUPPOSED ACUTE APPENDICITIS WITH LOW FREQUENCY CURVILINEAR TRANSDUCER AND ITS RELATION WITH SURGICAL OUTCOME

Aim: To determine the diagnostic accuracy of low frequency curvilinear transducer as an ancillary emergency tool for clinical suspects of acute appendicitis and its association with surgical outcome.

Material and Methods: This cross-sectional study was conducted at the Radiology department Unit-II of Jinnah Hospital Lahore for one-year duration from May 2019 to May 2020. 89 cases (38 men, 51 women; age 12–70 years, mean age 37 years) of clinically suspected acute appendicitis were included. The clinical classification is based on the Alvarado score. Transabdominal ultrasound was performed using a 3.5 MHz low-frequency curvilinear transducer with the graduated compression technique, followed by a 7.5 MHz high-frequency linear transducer. All cases underwent appendectomy. The inflammation of the sample was assessed on the basis of histopathology.

Results: Out of 89 patients, 71 were typical and 18 atypical clinical signs and symptoms of acute appendicitis. On ultrasound, the appendix was visualized in 73 cases (82%) with a low-frequency transducer, compared to 78 cases (87.6%) with a high-frequency transducer. The sensitivity and specificity of the preoperative ultrasound examination were approximately 68.0% and 88.0%, respectively. It was also found that the link between ultrasound and histopathological diagnostic evidence is statistically significant (p = 0.000).

Conclusion: The negative appendix rate can be significantly reduced by thorough ultrasound examination using a low-frequency transducer, which is helpful in clinical evaluation.

Key words: acute appendicitis, ultrasound, transducer, sensitivity, specificity