Journal of Medical Ultrasonics

, Volume 41, Issue 4, pp 439–443 | Cite as

Evaluation of whether the ultrasonographic onion skin sign is specific for the diagnosis of an appendiceal mucocele

  • Toru Kameda
  • Fukiko Kawai
  • Nobuyuki Taniguchi
  • Kiyoka Omoto
  • Yasuyuki Kobori
  • Kazukiyo Arakawa
Original Article
First Online:
Received:
Accepted:

Abstract

Purpose

To evaluate whether the onion skin sign on ultrasonography (US) of the lower abdomen is specific for the diagnosis of an appendiceal mucocele.

Methods

Our study included 231 lesions from 229 patients in whom transabdominal US detected lesions in the lower abdomen and who had definitive pathological diagnoses in the small bowel, ileocecal valve, cecum, appendix, mesentery, adnexa uteri or pelvic cavity outside the major organs. Patients with metastatic tumors were excluded. We reviewed the reports and images from transabdominal US and checked for the presence of the onion skin sign. The sensitivity, specificity, and accuracy of the sign for the diagnosis of an appendiceal mucocele were calculated.

Results

Five (2.2 %) of the 231 lesions showed the onion skin sign on US and all were diagnosed with an appendiceal mucocele. The sensitivity, specificity, and accuracy of the sign for the diagnosis of an appendiceal mucocele were 63, 100, and 99 %, respectively.

Conclusions

The onion skin sign in the lower abdomen appears to be specific for the diagnosis of an appendiceal mucocele. In cases where the onion skin sign is obviously present in the lower abdomen on US, an appendiceal mucocele should be considered as the leading diagnosis.

Keywords

Appendix Mucocele Ultrasonography Onion skin sign 
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Notes

Conflict of interest

Toru Kameda, Fukiko Kawai, Nobuyuki Taniguchi, Kiyoka Omoto, Yasuyuki Kobori, and Kazukiyo Arakawa declare that they have no conflict of interest.

Ethical statements

This was a retrospective chart review, and it was performed under the approval of the ethics committee at our institution.

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Copyright information

© The Japan Society of Ultrasonics in Medicine 2014

Authors and Affiliations

  • Toru Kameda
    • 1
  • Fukiko Kawai
    • 1
  • Nobuyuki Taniguchi
    • 2
  • Kiyoka Omoto
    • 3
  • Yasuyuki Kobori
    • 4
  • Kazukiyo Arakawa
    • 5
  1. 1.Department of Ultrasound MedicineSaiseikai Utsunomiya HospitalUtsunomiyaJapan
  2. 2.Department of Clinical Laboratory MedicineJichi Medical UniversityShimotsukeJapan
  3. 3.Department of Laboratory MedicineSaitama Medical Center, Jichi Medical UniversitySaitamaJapan
  4. 4.Department of Clinical LaboratorySaiseikai Utsunomiya HospitalUtsunomiyaJapan
  5. 5.Department of RadiologySaiseikai Utsunomiya HospitalUtsunomiyaJapan

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