Department of Radiology; Section of Pediatric Radiology, C.S. Mott Children's Hospital University of Michigan Medical Center, Ann Arbor, MI 48109-4252, USA.
Pediatr Radiol. 2012 Jul;42(7):813-23. doi: 10.1007/s00247-012-2358-6. Epub 2012 Mar 9.
We have observed that day-to-day use of US for acute appendicitis does not perform as well as described in the literature.
Review the diagnostic performance of US in acute appendicitis with attention to factors that influence performance.
Retrospective review of all sonograms for acute appendicitis in children from May 2005 to May 2010 with attention to the rate of identification of the appendix, training of personnel involved and diagnostic accuracy.
The appendix was identified in 246/1,009 cases (24.4%), with identification increasing over time. The accuracy of US was 85-91% with 35 false-positives and 54 false-negatives. Pediatric sonographers were significantly better at identifying the appendix than non-pediatric sonographers (P < 0.0001). Increased weight was the only patient factor that influenced identification of the appendix (P = 0.006). CT use was stable over the 5 years but declined in cases where the appendix was identified by US.
In day-to-day use, US does not perform as purported in the literature. We do not visualize the appendix as often as we should and false-negative and false-positive exams are too common. To improve the diagnostic performance of this modality, involvement by experienced personnel and/or additional training is needed.
我们发现，日常使用 US 诊断急性阑尾炎的效果并不像文献中描述的那样好。
回顾 US 在急性阑尾炎诊断中的表现，并关注影响其性能的因素。
对 2005 年 5 月至 2010 年 5 月期间所有儿童急性阑尾炎的超声图像进行回顾性分析，重点关注阑尾的检出率、相关人员的培训情况以及诊断的准确性。
在 1009 例患者中，246 例（24.4%）阑尾可被识别，且检出率随时间推移而增加。US 的准确性为 85-91%，有 35 例假阳性和 54 例假阴性。儿科超声医师识别阑尾的能力明显优于非儿科超声医师（P<0.0001）。体重增加是唯一影响阑尾识别的患者因素（P=0.006）。在 5 年期间 CT 的使用率保持稳定，但在 US 可识别阑尾的情况下，其使用率有所下降。
在日常使用中，US 的表现并不像文献中描述的那样好。我们并没有像应该的那样经常看到阑尾，假阴性和假阳性检查也太常见了。为了提高该方法的诊断性能，需要有经验的人员参与和/或额外的培训。
