Revised ultrasound criteria for appendicitis in children improve diagnostic accuracy

Abstract

These findings identify new US criteria that compare favorably to CT. In children with suspected appendicitis, using US as the initial imaging study will ultimately lead to improved accuracy, lower cost and the elimination of ionizing radiation exposure.

Development and validation of an ultrasound scoring system for children with suspected acute appendicitis

“…The sensitivity of US ranges from 42% to 90% in recently reported studies [4,11]. The sensitivity of CT is more often reported as high, with a range of 85-95% [12][13][14].…”

“…We evaluated the diagnostic performance of the size of the appendix using a receiver operator curve (Fig. 4) and found that a size threshold of 7.5 mm provided the best balance between sensitivity and specificity, which is slightly higher than our initial size threshold of 6.0 mm [4,5].…”

Searching for certainty: findings predictive of appendicitis in equivocal ultrasound exams

“…Increasing this size threshold has been suggested to improve diagnostic performance [20]. Goldin et al [22] reported improved sensitivity and specificity using a diameter of 7.5 mm. An additional study that looked at appendiceal diameters of both 6 mm and 7 mm found that diameter did not independently predict appendicitis [18].…”

A critical evaluation of US for the diagnosis of pediatric acute appendicitis in a real-life setting: how can we improve the diagnostic value of sonography?

“…Such errors are either the result of inappropriate diagnostic criteria or the result of inappropriate application of diagnostic criteria. Goldin et al [30] recently proposed revised diagnostic criteria for appendicitis in children that call into question the 6-mm maximum outer diameter that has traditionally been used. Among our falsepositive exams, a noncompressible appendix is the most common positive finding; described in 28 of the 35 cases.…”