Role of Duplex Doppler in Accurate Diagnosis of Appendicitis

NCT ID: NCT04130074

Last Updated: 2020-06-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-07-05

Study Completion Date

2021-03-15

Brief Summary

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To evaluate the role of duplex doppler in diagnosis of appendicitis compared to CT

Detailed Description

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Acute appendicitis (AA) is the most common acute abdominal condition worldwide \[1\]

Thus far, the clinical diagnosis of (AA) remains a challenge to emergency physicians and surgeons both in the pediatric and adult populations, as the symptoms are often atypical and overlapped with various other diseases\[2\],\[3\].

The accurate diagnosis of AA depends on both clinical presentations and imaging techniques.

To date, US and computed tomography (CT) remain the most common used diagnostic imaging, and CT is considered the gold standard technique to evaluate patients with suspected AA, because of its high sensitivity and specificity \[2\],\[3\]. While the associated radiation exposure remains a concern, especially, among children, the elderly and pregnant women, as radiation protection is of major importance \[2\],\[3\],\[5\],\[6\].

Over recent years, research on various aspects of US imaging in the diagnosis of (AA) has gained major importance due to its radiation protection, broad availability and cost-effectiveness \[6\].

Therefore,US may be valuable as an initial imaging choice for patients with suspected (AA) or with equivocal clinical presentations \[7\],\[8\].

With continuing efforts to improve the diagnostic performance of US, a variety of US findings have been described for use in the setting of suspected appendicitis, including the maximum outer diameter (MOD), periappendiceal fluid, echogenic periappendiceal fat, and loss of the normally echogenic submucosal layer within the appendiceal wall \[9\] ,\[10\].

Color Doppler imaging has been utilized as well, with early reports describing no detectable flow in the normal appendix and later reports, with the benefit of improved instrumentation, d describing flow in normal appendices and hyperemia in inflamed appendices \[11\],\[12\].

However, objective criteria for interpreting Doppler results generally have not been specifically described \[11\],\[13\],\[12\],\[14\].

.Spectral Doppler imaging, in contrast to color Doppler imaging, provides inherently objective, quantitative data such as peak systolic velocity (PSV) and resistive index (RI) values. These measurements have found utility in the assessment of the carotid arteries and, for example, both native as well as transplanted hepatic and renal vessels\[16\],\[17\]. Early investigations addressed the RI in appendicitis as well, without emphasis on the PSV, using instrumentation that was modern for the time \[18\],\[19\],\[20\].

Conditions

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Appendicitis Acute

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

CROSS_SECTIONAL

Interventions

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duplex doppler ultra sound and CT

graded compression US done in different positions then take MSCT with contrast on abdomen to compare with

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients with acute abdomen and suspected appendicitis.

Exclusion Criteria

* so Obese and irritable Patients whom satisfactory graded compression US can't be done.
* pregnant women , children under 3 years old and adults over 60 years old for radiation hazards.
* patients with renal impairment for contrast hazards.
Minimum Eligible Age

3 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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abdelRahman Ahmad abdAllah

OTHER

Sponsor Role lead

Responsible Party

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abdelRahman Ahmad abdAllah

resident doctor

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Diagnostic Radiology Department of the assiut university hospital

Asyut, , Egypt

Site Status

Countries

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Egypt

Central Contacts

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abdelrahman ahmed abdallah, bachelor

Role: CONTACT

01006828820

Gehan Sayed Ahmed, assistant professor

Role: CONTACT

01224417605

References

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Blitman NM, Anwar M, Brady KB, Taragin BH, Freeman K. Value of Focused Appendicitis Ultrasound and Alvarado Score in Predicting Appendicitis in Children: Can We Reduce the Use of CT? AJR Am J Roentgenol. 2015 Jun;204(6):W707-12. doi: 10.2214/AJR.14.13212.

Reference Type BACKGROUND
PMID: 26001260 (View on PubMed)

Humes DJ, Simpson J. Acute appendicitis. BMJ. 2006 Sep 9;333(7567):530-4. doi: 10.1136/bmj.38940.664363.AE. No abstract available.

Reference Type BACKGROUND
PMID: 16960208 (View on PubMed)

Shogilev DJ, Duus N, Odom SR, Shapiro NI. Diagnosing appendicitis: evidence-based review of the diagnostic approach in 2014. West J Emerg Med. 2014 Nov;15(7):859-71. doi: 10.5811/westjem.2014.9.21568. Epub 2014 Oct 7.

Reference Type BACKGROUND
PMID: 25493136 (View on PubMed)

Mostbeck G, Adam EJ, Nielsen MB, Claudon M, Clevert D, Nicolau C, Nyhsen C, Owens CM. How to diagnose acute appendicitis: ultrasound first. Insights Imaging. 2016 Apr;7(2):255-63. doi: 10.1007/s13244-016-0469-6. Epub 2016 Feb 16.

Reference Type BACKGROUND
PMID: 26883138 (View on PubMed)

Brenner D, Elliston C, Hall E, Berdon W. Estimated risks of radiation-induced fatal cancer from pediatric CT. AJR Am J Roentgenol. 2001 Feb;176(2):289-96. doi: 10.2214/ajr.176.2.1760289.

Reference Type BACKGROUND
PMID: 11159059 (View on PubMed)

Hernandez JA, Swischuk LE, Angel CA, Chung D, Chandler R, Lee S. Imaging of acute appendicitis: US as the primary imaging modality. Pediatr Radiol. 2005 Apr;35(4):392-5. doi: 10.1007/s00247-004-1372-8. Epub 2005 Jan 6.

Reference Type BACKGROUND
PMID: 15635471 (View on PubMed)

Rice HE, Arbesman M, Martin DJ, Brown RL, Gollin G, Gilbert JC, Caty MG, Glick PL, Azizkhan RG. Does early ultrasonography affect management of pediatric appendicitis? A prospective analysis. J Pediatr Surg. 1999 May;34(5):754-8; discussion 758-9. doi: 10.1016/s0022-3468(99)90369-x.

Reference Type BACKGROUND
PMID: 10359177 (View on PubMed)

Chan L, Shin LK, Pai RK, Jeffrey RB. Pathologic continuum of acute appendicitis: sonographic findings and clinical management implications. Ultrasound Q. 2011 Jun;27(2):71-9. doi: 10.1097/RUQ.0b013e31821b6eea.

Reference Type BACKGROUND
PMID: 21606789 (View on PubMed)

Trout AT, Towbin AJ, Fierke SR, Zhang B, Larson DB. Appendiceal diameter as a predictor of appendicitis in children: improved diagnosis with three diagnostic categories derived from a logistic predictive model. Eur Radiol. 2015 Aug;25(8):2231-8. doi: 10.1007/s00330-015-3639-x. Epub 2015 Apr 28.

Reference Type BACKGROUND
PMID: 25916384 (View on PubMed)

Ohba G, Hirobe S, Komori K. The Usefulness of Combined B Mode and Doppler Ultrasonography to Guide Treatment of Appendicitis. Eur J Pediatr Surg. 2016 Dec;26(6):533-536. doi: 10.1055/s-0035-1570756. Epub 2016 Jan 8.

Reference Type BACKGROUND
PMID: 26745520 (View on PubMed)

Gaitini D, Beck-Razi N, Mor-Yosef D, Fischer D, Ben Itzhak O, Krausz MM, Engel A. Diagnosing acute appendicitis in adults: accuracy of color Doppler sonography and MDCT compared with surgery and clinical follow-up. AJR Am J Roentgenol. 2008 May;190(5):1300-6. doi: 10.2214/AJR.07.2955.

Reference Type BACKGROUND
PMID: 18430847 (View on PubMed)

Kessler N, Cyteval C, Gallix B, Lesnik A, Blayac PM, Pujol J, Bruel JM, Taourel P. Appendicitis: evaluation of sensitivity, specificity, and predictive values of US, Doppler US, and laboratory findings. Radiology. 2004 Feb;230(2):472-8. doi: 10.1148/radiol.2302021520. Epub 2003 Dec 19.

Reference Type BACKGROUND
PMID: 14688403 (View on PubMed)

Linam LE, Munden M. Sonography as the first line of evaluation in children with suspected acute appendicitis. J Ultrasound Med. 2012 Aug;31(8):1153-7. doi: 10.7863/jum.2012.31.8.1153. No abstract available.

Reference Type BACKGROUND
PMID: 22837278 (View on PubMed)

Baldisserotto M, Peletti AB. Is colour Doppler sonography a good method to differentiate normal and abnormal appendices in children? Clin Radiol. 2007 Apr;62(4):365-9. doi: 10.1016/j.crad.2006.11.009. Epub 2007 Jan 30.

Reference Type BACKGROUND
PMID: 17331831 (View on PubMed)

Other Identifiers

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US in appendecitis

Identifier Type: -

Identifier Source: org_study_id

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