Sonography Ideal to Assess Patients with Suspected Appendicitis
A recent study published in the American Journal of Roentgenology noted the utility of color Doppler ultrasound as a diagnostic tool to assess patients who are suspected of having acute appendicitis. The research team suggests that this method should be the first imaging modality employed to assess disease.
The research team in Israel, from the Rambam Health Care Campus, commenced the study to compare the utility of sonography with contrast-enhanced multi-detector computed tomography (MDCT) in patients who present with acute right lower quadrant pain.
Between January 2003 and June 2006, such patients underwent ultrasound evaluation after referral from the emergency room. In total, data from 420 patients was considered. Of the patients examined, 132 patients went on to undergo MDCT because sonography results were inconclusive or there was a discrepancy between sonography results and clinical diagnosis.
Of the patients examined, ultrasound accurately diagnosed appendicitis in 66 of 75 cases. The disease was ruled out correctly in 312 of 326 patients. The sensitivity and specificity of the test was documented at 74.2 and 97 percent, respectively.
CT, alternatively, yielded inconclusive findings in only one case. Acute appendicitis was diagnosed correctly in 38 of 39 cases and ruled out disease in 92 cases. The sensitivity for CT was 100 percent and specificity was marked at 98.9 percent.
The group noted that computed tomography should be reserved for those cases where images procured with ultrasound are insufficient for making a definitive diagnosis and clinical suspicion is still high for appendicitis. This recommendation was issued in light of reducing the amount of radiation exposure to which patients are exposed.
May 29, 2008 Related topics: Imaging, Diagnostic