Objective To analyze the accuracy of color Doppler ultrasound in diagnosing and distinguishing acute appendicitis and mesenteric lymphadenitis in children.Methods Seventy-six children with abdominal pain suspected of acute appendicitis or mesenteric lymphadenitis admitted to our pediatric department from March 2020 to March 2023 were selected for color Doppler ultrasound examination and histopathological examination.The accuracy of color Doppler ultrasound in the differential diagnosis of acute appendicitis and mesenteric lymphadenitis in children,as well as the sonographic characteristics of different diseases,were evaluated based on the results of histopathological examination as the gold standard.Results Among the 76 pediatric patients,47 cases were diagnosed with acute appendicitis by histopathology,29 cases with mesenteric lymphadenitis,46 cases with acute appendicitis by color Doppler ultrasound,and 30 cases with mesenteric lymphadenitis.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of color Doppler ultrasound in distinguishing acute appendicitis in children were 97.9％(47/48),100％(29/29),97.9％(46/47),100％(47/47),and 96.7％(29/30),respectively.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of color Doppler ultrasound in the diagnosis and differentiation of pediatric mesenteric lymphadenitis were 100％(29/29),97.9％(47/48),98.7％(75/76),96.7％(29/30),and 100％(47/47),respectively.There is a significant difference in the ultrasound characteristics between acute appendicitis and mesenteric lymphadenitis in children.Among them,the appendix in children with acute appendicitis is enlarged,with irregular low echoes,rich blood flow signals,and irregular blood flow characteristics.Children with mesenteric lymphadenitis have enlarged lymph nodes with uniform hypoechogenicity,rich blood flow signals,and regular blood flow characteristics.Conclusion Color Doppler ultrasound has a high accuracy in diagnosing and distinguishing acute appendicitis and mesenteric lymphadenitis in children,and is worthy of clinical promotion and application.
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