The Usefulness of Combined B Mode and Doppler Ultrasonography to Guide Treatment of XXXX .

@entity1 @entity32 @entity697 @entity698 @entity2466 @entity39 @entity551
UNASSIGNED: Introduction   We have succeeded in classifying the severity of @entity698 by evaluating the structure of the submucosal layer and blood flow in the appendix wall with ultrasonography (US). Here, we propose a new preoperative classification system to guide treatment strategy. Materials and Methods   Between February 2005 and December 2011, a total of 440 @entity697 cases were diagnosed, and 407 met inclusion criteria for this study. US and Doppler findings were used to classify cases as Grade I, IIa, IIb, III, or @entity2466 . Grades I and IIa were treated conservatively without antibiotics. Appendectomy for Grades IIb and III and interval appendectomy for @entity2466 were performed. Results   Of 407 cases, 38 were Grade I, 132 were Grade IIa, 130 were Grade IIb, 57 were Grade III, and 50 were @entity2466 . Improvement occurred without antibiotics in 37 (97.3%) Grade I and 129 (97.7%) Grade IIa cases. Recurrence occurred postdischarge in 9 (23.6%) Grade I and 35 (26.5%) Grade IIa cases. All Grades IIb and III @entity1 had gangrenous or phlegmonous @entity698 . There were no negative appendectomies. Conclusion   Even if US findings reveal swelling or an irregular submucosal layer, when power Doppler identifies abundant blood flow, @entity32 may improve spontaneously. @entity551 indicates irreversible @entity39 change. Doppler and B-mode US used together improve @entity697 treatment.
