Cobben L P, Bakker O J, Puylaert J B, Kingma L M, Blickman J G
Department of Radiology, Medisch Centrum Haaglanden, Lijnbaan 32, 2501 CK Den Haag, The Netherlands.
Br J Radiol. 2009 Jun;82(978):482-5. doi: 10.1259/bjr/31522537. Epub 2008 Dec 19.
The aim of this study was to summarize the extent of variation in imaging strategies in patients clinically suspected of having appendicitis. By means of a written survey, the policies for the imaging management of patients clinically suspected of having appendicitis in the Netherlands were inventoried. A questionnaire was sent to the departments of surgery and radiology of all 105 Dutch hospitals, including the 8 academic medical centres, in March 2006. Questionnaires were returned from 98 hospitals. It was found that, in the work-up of patients suspected of having appendicitis, ultrasound or CT was performed in a minority of hospitals for 50% or more of these patients. In the majority of hospitals, it was carried out for less than 50% of these patients. There is a widespread variability in pre-operative imaging regardless of hospital type. This survey shows that, despite the ubiquitous presence of ultrasound and CT in Dutch hospitals, the pre-operative imaging work-up in patients clinically suspected of having acute appendicitis does not reflect this, being performed in only a minority of patients suspected of having acute appendicitis. Radiologists and surgeons alike should be aware of the positive impact of adjunctive imaging in this group of patients - most importantly lowering the negative appendicectomy rate and also lowering total hospital costs.
本研究的目的是总结临床疑似阑尾炎患者成像策略的变化程度。通过书面调查，对荷兰临床疑似阑尾炎患者的成像管理策略进行了清查。2006年3月，向荷兰所有105家医院（包括8家学术医疗中心）的外科和放射科发送了一份调查问卷。98家医院回复了问卷。结果发现，在对疑似阑尾炎患者的检查过程中，少数医院对50%或更多此类患者进行了超声或CT检查。在大多数医院，此类检查针对的患者不到50%。无论医院类型如何，术前成像都存在广泛的差异。这项调查表明，尽管荷兰医院普遍配备了超声和CT，但临床疑似急性阑尾炎患者的术前成像检查并未体现这一点，仅对少数疑似急性阑尾炎患者进行了检查。放射科医生和外科医生都应意识到辅助成像对这类患者的积极影响——最重要的是降低阴性阑尾切除率并降低总住院费用。
