Department of Radiology (Suite G1-227), Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Eur Radiol. 2011 Jul;21(7):1535-45. doi: 10.1007/s00330-011-2087-5. Epub 2011 Mar 2.
Head-to-head comparison of ultrasound and CT accuracy in common diagnoses causing acute abdominal pain.
Consecutive patients with abdominal pain for >2 h and <5 days referred for imaging underwent both US and CT by different radiologists/radiological residents. An expert panel assigned a final diagnosis. Ultrasound and CT sensitivity and predictive values were calculated for frequent final diagnoses. Effect of patient characteristics and observer experience on ultrasound sensitivity was studied.
Frequent final diagnoses in the 1,021 patients (mean age 47; 55% female) were appendicitis (284; 28%), diverticulitis (118; 12%) and cholecystitis (52; 5%). The sensitivity of CT in detecting appendicitis and diverticulitis was significantly higher than that of ultrasound: 94% versus 76% (p < 0.01) and 81% versus 61% (p = 0.048), respectively. For cholecystitis, the sensitivity of both was 73% (p = 1.00). Positive predictive values did not differ significantly between ultrasound and CT for these conditions. Ultrasound sensitivity in detecting appendicitis and diverticulitis was not significantly negatively affected by patient characteristics or reader experience.
CT misses fewer cases than ultrasound, but both ultrasound and CT can reliably detect common diagnoses causing acute abdominal pain. Ultrasound sensitivity was largely not influenced by patient characteristics and reader experience.
比较超声和 CT 在引起急性腹痛的常见诊断中的准确性。
连续就诊于影像科的腹痛时间>2 小时且<5 天的患者由不同的放射科医生/放射科住院医师进行超声和 CT 检查。专家组给出最终诊断。计算常见最终诊断的超声和 CT 敏感度和预测值。研究患者特征和观察者经验对超声敏感度的影响。
1021 例患者（平均年龄 47 岁；55%为女性）的常见最终诊断为阑尾炎（284 例；28%）、憩室炎（118 例；12%）和胆囊炎（52 例；5%）。CT 检测阑尾炎和憩室炎的敏感度明显高于超声：94%比 76%（p<0.01）和 81%比 61%（p=0.048），分别。对于胆囊炎，两种方法的敏感度均为 73%（p=1.00）。对于这些疾病，超声和 CT 的阳性预测值之间无显著差异。超声检测阑尾炎和憩室炎的敏感度不受患者特征和读者经验的显著影响。
CT 漏诊的病例少于超声，但超声和 CT 均可可靠地检测引起急性腹痛的常见诊断。超声的敏感度在很大程度上不受患者特征和读者经验的影响。
