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Role of CT and USG in suspected appendicitis
What are the test characteristics of ultrasound and computed tomography (CT) for the evaluation of children with suspected appendicitis?
- Ultrasonography is beneficial because it does not expose the child to ionizing radiation. However, it is operator dependent and may have limited use in obese children.
- Ultrasound can reach sensitivities of 90% and specificities of 97% for appendicitis with an experienced operator.
- However, if ultrasound does not visualize the appendix, appendicitis cannot be ruled out. Then, CT scan may be helpful (or perhaps MRI—see [CR] ).
- CT is less operator dependent than ultrasonography, may provide several alternate diagnoses, and has excellent reported test characteristics in children. The sensitivity is up to 97% and specificity is 97%.
Sources
Doria AS, Moineddin R, Kellenberger CJ, et al: US or CT for diagnosis of appendicitis in children and adults? A metaanalysis. Radiol 2006;241:83-94.
Krishnamoorthi R, Ramarajan N, Wang N, et al: Effectiveness of a staged US and CT protocol for the diagnosis of pediatric appendicitis: reducing radiation exposure in the age of ALARA. Radiol 2011;259:231-239.
