3 3 steps positioning algorythm
Ultrasound Gut Layer
5 Layers
Echogenic mucosal surface
Hypoechoic mucosa
Echogenic submucosa
Hypoechoic muscularis propria
Echogenic serosal fat
US signs of Appendicitis
Ileum과 차이점 : Appendix는 inner hypoechogenic mucosa에 fold가 없음.
Appendix는 mucosa가 왜 두꺼운가 - lymphoid tissue 때문
Maximal outer diameter : Maximal mural thickness
Muscularis layer에서부터 반대편 muscularis layer까지 잰다
Threshold : 6mm (민감도는 높으나, 특이도는 낮다)
Lack of compressibility
96% 민감도와 특이도
Hyperemia
Hyperemia는 염증의 중요한 지표
염증있는 appendix wall은 color doppler에서 hypremic 하다
민감도 52%, 특이도 96%
Tip Appendicitis
Inflammation localizing to the distal third portion of the appendix
Can be a cause for false-negative US diagnoses
Entire length of the appendix should be carefully evaluated in every case
이 환자는 appendicolith있고 tip 직경은 1.5cm. 01613228
PERIAPPENDICEAL MESENTERIC FAT
Increased thickening and hyperechogenicity of periappendiceal mesenteric fat is an important and highly specific
(98% specificity; 73% sensitivity)
충수 초음파 표준영상 및 기술내용
