Abstracts S157

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Comparison of US and CT in the Classifications of Types ofNasal FracturesHeung Cheol Kim, Dept. of Radiology, Hallym Univ. Hospital,Chuncheon, Korea

Purpose: The aim of the study was to compare the sonographic and CTclassifications of the type of nasal fractures.Materials and Methods: 72 patients with nasal trauma were investi-gated. All patients underwent US (5--12 MHz linear array transducer)and axial CT scans. The fractures classifications by US findings werecompared with the classifications by CT findings.Nasal fractures were classified into the followings.Type 1: no fracture or fracture without displacement.Type 2: fracture with unilateral displacement / without posterior dis-placement.Type 3: fracture with bilateral displacement / without posterior dis-placement.Type 4: fracture with posterior displacement / without lateral displace-ment.Type 5: fracture with bilateral and posterior displacement.The ?2 test and � values were used to compare the results between the2 diagnostic tools (US and CT).Results: The nasal bone fractures classified by CT findings were type1(31 cases, 43%), type 2(19 cases, 26%), type 3(14 cases, 19%), type4(5 cases, 6% ), type 5(3 cases, 4%) and by US findings were type 1(22cases, 30%), type 2(27 cases, 37%), type 3(11 cases, 15%), type 4(6cases, 8%), type 5(6 cases, 8%). The � test showed a good correspon-dence between 2 diagnostic tools (� �0.563).The ?2 test showed no statistical significant difference was foundbetween US and CT in the classifications of the nasal bone fracture(p�0.358).Conclusion: Ultrasonic investigation of the nasal bone is a useful wayto classify the fracture types that provides similar results to CT.

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Added Value of Color Doppler Ultrasonography in AcuteAppendicitis: Preliminary Study for Prediction of PerforationMin Yeong Kim, Department of Radiology, Korea University AnsanHospital, KoreaSang Hoon Cha, Department of Radiology, Korea University AnsanHospital, KoreaHwan Hoon Chung, Department of Radiology, Korea UniversityAnsan Hospital, KoreaSeung Hwa Lee, Department of Radiology, Korea University AnsanHospital, KoreaBo Kyung Je, Department of Radiology, Korea University AnsanHospital, Korea

Purpose: To investigate the added value of color Doppler ultrasonog-raphy in patients with acute appendicitis, focusing on risk of perfora-tion.Materials & Methods: On retrospective review of ultrasonographywith surgically-proven acute appendicitis, fourteen patients underwentsimultaneous color Doppler exams. All ultrasonographic exams wereanalyzed with maximal diameter, maximal mural thickness, intralumi-nal contents, loss of mural integrity, periappendiceal fat echogenicity,amount of loculated periappendiceal fluid/abscess and the color signalpatterns in whole appendix. In each gray-scale ultrasonography andadded color Doppler exams, the confidence for probability of perfora-

tion was graded using a four point scale (1, no risk; 2, low risk; 3, high

risk; 4, definite perforation) and compared with surgical and pathologicreports as reference standards.Results: Eight of 14 patients were in high risk of perforationincluding 5 gangrenous and 3 perforated appendicitis on referencestandards. The amount of loculated periappendiceal fluid or abscesswas not enough to be seen on ultrasonography. Excessively in-creased periappendiceal fat echogenicity was highly specific regard-less of color Doppler ultrasonography but evident in only twopatients. Color Doppler ultrasonography was helpful in 8 patientswith increased accuracy and confidence for risk of perforation andtwo specific findings were focal loss of color signal in backgroundincreased blood flow of appendix and absence of color signal in theentire appendix. There was no significant association between othercharacteristics and risk of perforation.Conclusion: Adding color Doppler ultrasonographic exams improvedpredictability of perforation with increased accuracy and confidenceduring routine gray-scale ultrasonography of acute appendicitis.

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Where is Ultrasonographics Exams for Acute Appendicitis inMDCT Era? - Direct Comparison of Ultrasonography withMDCT in Same PatientsMin Yeong Kim, Department of Radiology, Korea University AnsanHospital, KoreaSang Hoon Cha, Korea University Ansan Hospital, Korea UniversityCollege of Medicine, KoreaHwan Hoon Chung, Department of Radiology, Korea UniversityAnsan Hospital, KoreaSeung Hwa Lee, Korea University Hospital, KoreaBo Kyung Je, Department of Radiology, Korea University AnsanHospital, Korea

Purpose: To directly compare of diagnostic accuracy and confidenceof ultrasonography with MDCT for acute appendicitis with/withoutcomplication in same patients and to analyze affecting factors todiagnostic performance.Learning Objects: To understand different characteristics betweenultrasonography and MDCT for evaluation of appendiceal abnormali-ties. To analyze the false negative results of MDCT in acute appendi-citis despite correct ultrasonographic diagnoses. To evaluate addedvalues of color Doppler exams for diagnosis of acute appendicitis andcomplication. To help with choosing the first diagnostic modalitybetween ultrasonography and MDCT. To consider surgeons’ views ofdiagnostic modalities.Conclusion: Though MDCT is accurate and surgeons’ preference,ultrasonographic exam must be considered the first diagnostic modalityin patients with acute appendicitis.

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Ultrasound Findings of Torn Greater OmentumVan Nghiep Nguyen, MD, VietnamVu Quang Duong, MD, VietnamHung Thien Nguyen, MD, VietnamHai Thanh Phan, MD, Vietnam

Purpose: To report 2 rare cases of hemoperitoneum caused by torngreater omentum.Materials and Methods: Abdominal ultrasound first , and then ab-dominal punction and surgery confirmed.Results: 2 male patients 32-44 y.o were seen with diffuse abdom-

inal pain of 24-48 hours duration. They had no fever, nausea, or