Ultrasound, computed tomography or magnetic resonance imaging - which is preferred for acute appendicitis in children? A Meta-analysis

Abstract

US, CT and MRI have high diagnostic accuracies of clinically suspected acute appendicitis in children overall with no significant difference.

Performance of MRI for suspected appendicitis in pediatric patients and negative appendectomy rate: A systematic review and meta‐analysis

“…We believe that this new information may contribute to the use of MRI for pediatric patients with suspected appendicitis. The pooled sensitivity and specificity reported in the three previous systematic reviews and meta‐analyses ranged from 96% to 98% and from 96% to 97%, respectively, which were similar to those of our meta‐analysis …”

“…The pooled sensitivity and specificity reported in the three previous systematic reviews and meta-analyses ranged from 96% to 98% and from 96% to 97%, respectively, which were similar to those of our meta-analysis. [23][24][25] Compared with US, MRI showed higher diagnostic performance for acute appendicitis in terms of pooled sensitivity (78-88% in US vs. 97% in MRI) and specificity (83-94% in US vs. 97% in MRI). 8,39 MRI also had slightly higher pooled sensitivity (91-94% in CT vs. 97% in MRI) and specificity (90-95% in CT vs. 97% in MRI) than CT. 8,39 According to the meta-regression, the use of DWI and age were associated with heterogeneity.…”

“…Three previously published systematic reviews and meta‐analyses have investigated the diagnostic performance of MRI for acute appendicitis in children . Nonetheless, we performed this current meta‐analysis for the following reasons.…”

“…Three previously published systematic reviews and meta-analyses have investigated the diagnostic performance of MRI for acute appendicitis in children. [23][24][25] Nonetheless, we performed this current meta-analysis for the following reasons. First, we included a greater number of recently published articles (ie, 13 studies); previous studies only included a small number of studies, from 4 to 11.…”

“…Its high soft‐tissue contrast resolution, lack of ionizing radiation, and reduced operator dependency are strong advantages in children. Despite a substantial number of studies on the use of MRI in the evaluation of acute appendicitis in children and adolescents, there are only a few published systematic reviews and meta‐analyses . Hence, we conducted a systematic review and meta‐analysis with a larger number of included studies and using hierarchical models to evaluate the diagnostic performance of MRI and the negative appendectomy rate for suspected appendicitis in pediatric patients.…”