By AuntMinnie.com staff writers

June 22, 2018 -- Ultrasound, CT, and MRI are all viable supplemental imaging modalities for assessing acute appendicitis after initial ultrasound, according to a study published online June 19 in Radiology.

The team led by Dr. Kevin Eng conducted a literature search on Medline and Embase, identifying studies that used surgery or histopathologic exam information alone or in combination with clinical follow-up or chart review to assess the diagnostic accuracy of supplemental imaging modalities for appendicitis.

Studies included the following:

  • For children -- ultrasound: six studies and 548 patients; CT: nine studies and 1,498 patients; MRI: five studies and 287 patients
  • For adults -- ultrasound: three studies and 169 patients; CT: 11 studies and 1,027 patients; MRI: six studies and 427 patients

All three modalities had comparable, high accuracy for diagnosing the disease, both in children and adults, the researchers found.

Pooled sensitivities and specificities of second-line imaging for diagnosing appendicitis
Measure Ultrasound CT MRI
Sensitivity: Adults 83.1% 89.9% 97.4%
Sensitivity: Children 91.3% 96.2% 89.9%
Specificity: Adults 90.9% 93.6% 97.1%
Specificity: Children 95.2% 94.6% 93.6%

"All three modalities may be valid as second-line imaging in a clinical imaging pathway for diagnosis and management of appendicitis," they concluded.


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