Reddan Tristan, Corness Jonathan, Mengersen Kerrie, Harden Fiona
Lady Cilento Children's Hospital Children's Health Queensland South Brisbane Qld Australia; School of Mathematics Science and Engineering Faculty Queensland University of Technology Brisbane Qld Australia; Institute of Health and Biomedical Innovation Queensland University of Technology Kelvin Grove Qld Australia.
Lady Cilento Children's Hospital Children's Health Queensland South Brisbane Qld Australia.
J Med Radiat Sci. 2016 Mar;63(1):59-66. doi: 10.1002/jmrs.154. Epub 2016 Jan 20.
Sonography is an important clinical tool in diagnosing appendicitis in children as it can obviate both exposure to potentially harmful ionising radiation from computed tomography scans and the need for unnecessary appendicectomies. This review examines the diagnostic accuracy of ultrasound in the identification of acute appendicitis, with a particular focus on the the utility of secondary sonographic signs as an adjunct or corollary to traditionally examined criteria. These secondary signs can be important in cases where the appendix cannot be identified with ultrasound and a more meaningful finding may be made by incorporating the presence or absence of secondary sonographic signs. There is evidence that integrating these secondary signs into the final ultrasound diagnosis can improve the utility of ultrasound in cases where appendicitis is expected, though there remains some conjecture about whether they play a more important role in negative or positive prediction in the absence of an identifiable appendix.
超声检查是诊断儿童阑尾炎的一项重要临床工具，因为它既能避免因计算机断层扫描而接触潜在有害的电离辐射，又能避免不必要的阑尾切除术。本综述探讨了超声在识别急性阑尾炎方面的诊断准确性，特别关注作为传统检查标准的辅助或补充的超声二级征象的效用。在超声无法识别阑尾的情况下，这些二级征象可能很重要，通过纳入超声二级征象的存在与否可能会得出更有意义的发现。有证据表明，将这些二级征象纳入最终的超声诊断可以提高超声在疑似阑尾炎病例中的效用，尽管在无法识别阑尾的情况下，它们在阴性或阳性预测中是否发挥更重要的作用仍存在一些推测。
