Role of CT and USG in suspected appendicitis

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.

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