Diagnostic value of maximal-outer-diameter and maximal-mural-thickness in use of ultrasound for acute appendicitis in children

Figure 1 Measurement of MOD and MMT of an appendix in the cross-sectional image. The MOD (A) of the appendix of a 10-year-old boy who had surgery for acute appendicitis. The MOD (B) and the MMT (C) of the appendix of a 7-year-old boy who had a normal appendix in spite of acute abdominal pain.

Figure 2 Data comparison graphs of MOD (A) and MMT (B) in box-and-whisker plots. The median MOD and the median MMT were significantly different (P < 0.0001) between two groups.

Figure 3 ROC curves of MOD (A) and MMT (B). The optimal cut-off points are marked as white square boxes on the graphs.

Figure 4 Cross-sectional image of a distended normal appendix in a 7-year-old boy. The MOD of the appendix was 0.65 cm. The intra-luminal hyperechogenicity was due to gas and fecal materials. We diagnosed this as normal appendix, and the symptoms spontaneously resolved.