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Sonography and Computed Tomography in Diagnosing Acute Appendicitis.

Mikayla E Hwang

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    |January 5, 2018
    PubMed
    Summary

    Sonography is an effective first-line diagnostic tool for acute appendicitis, offering cost savings. Abdominal computed tomography (CT) provides higher sensitivity and is recommended for inconclusive sonography findings in diagnosing appendicitis.

    Keywords:
    acute appendicitiscomparisoncomputed tomographymedical imagingsonography

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    Area of Science:

    • Radiology
    • Diagnostic Imaging
    • Gastroenterology

    Background:

    • Acute appendicitis is a common surgical emergency.
    • Accurate and timely diagnosis is crucial for effective treatment and preventing complications.
    • Imaging modalities play a vital role in diagnosing acute appendicitis.

    Purpose of the Study:

    • To systematically review and evaluate the diagnostic effectiveness of abdominal sonography and abdominal computed tomography (CT) for acute appendicitis.
    • To compare the diagnostic performance of sonography and CT in adult and pediatric populations.

    Main Methods:

    • A systematic literature review of peer-reviewed studies published between 1986 and 2014.
    • Inclusion criteria: human patients, >50 patients, reported diagnostic values, adult/pediatric populations (excluding pregnant women), and histological/clinical follow-up as reference standard.
    • Databases searched: multiple medical literature databases.

    Main Results:

    • Sonography demonstrated pooled sensitivity of 86%, specificity of 94%, PPV of 100%, and NPV of 92%.
    • CT showed pooled sensitivity of 95%, specificity of 94%, PPV of 95%, and NPV of 99%.
    • CT exhibited higher sensitivity and NPV compared to sonography.

    Conclusions:

    • Sonography is an effective initial diagnostic tool for acute appendicitis.
    • CT is a highly sensitive and specific modality, particularly useful for patients with inconclusive sonographic findings.
    • Unenhanced CT minimizes radiation exposure, especially in pediatric patients, while sonography can reduce costs associated with negative explorations.