Ultrasonography/mri versus ct for diagnosing appendicitis

Gudrun Aspelund, Abbey Fingeret, Erica Gross, David Kessler, Connie Keung, Arul Thirumoorthi, Pilyung Stephen Oh, Gerald Behr, Susie Chen, Brooke Lampl, William Middlesworth, Jessica Kandel, Carrie Ruzal-Shapiro

Research output: Contribution to journalArticlepeer-review

89 Scopus citations

Abstract

BACKGROUND: Cross-sectional imaging increases accuracy in diagnosing appendicitis. We hypothesized that a radiation-free imaging pathway of ultrasonography selectively followed by MRI would not change clinical end points compared with computed tomography (CT) for diagnosis of acute appendicitis in children. METHODS: We retrospectively reviewed children (,18 years old) who had diagnostic imaging for suspected acute appendicitis between November 2008 and October 2012. Before November 2010 CT was used as the primary imaging modality (group A); subsequently, ultrasonography was the primary imaging modality followed by MRI for equivocal findings (group B). Data collected included time from triage to imaging and treatment and results of imaging and pathology. RESULTS: Six hundred sixty-two patients had imaging for suspected appendicitis (group A = 265; group B = 397, of which 136 [51%] and 161 [41%], respectively, had positive imaging for appendicitis). Negative appendectomy rate was 2.5% for group A and 1.4% for group B. Perforation rate was similar for both groups. Time from triage to antibiotic administration and operation did not differ between groups A and B. There was higher proportion of positive imaging and appendectomies in group A and thus more negative imaging tests in group B (ultrasonography and MRI), but diagnostic accuracy of the 2 imaging pathways was similar. CONCLUSIONS: In children with suspected acute appendicitis, a radiationfree diagnostic imaging of ultrasonography selectively followed by MRI is feasible and comparable to CT, with no difference in time to antibiotic administration, time to appendectomy, negative appendectomy rate, perforation rate, or length of stay.

Original languageEnglish (US)
Pages (from-to)586-593
Number of pages8
JournalPediatrics
Volume133
Issue number4
DOIs
StatePublished - Apr 2014

Keywords

  • Appendicitis
  • Child
  • Computed tomography
  • MRI
  • Ultrasonography

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Fingerprint Dive into the research topics of 'Ultrasonography/mri versus ct for diagnosing appendicitis'. Together they form a unique fingerprint.

Cite this