Löfvenberg Fanny, Salö Martin
Department of Clinical Sciences, Pediatrics, and Department of Pediatric Surgery, Lund University, Skåne University Hospital, Lund, Sweden.
Biomed Res Int. 2016;2016:5697692. doi: 10.1155/2016/5697692. Epub 2016 Dec 1.
. To evaluate the performance of ultrasound in pediatric appendicitis and the integration of US with the pediatric appendicitis score (PAS) and C-reactive protein (CRP). . An institution-based, retrospective study of children who underwent abdominal US for suspected appendicitis between 2012 and 2015 at a tertiary pediatric surgery center. US results were dichotomized, with a nonvisualized appendix considered as a negative examination. . In total, 438 children were included (mean 8.5 years, 54% boys), with an appendicitis rate of 29%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for US were 82%, 97%, 92%, and 93%, respectively, without significant age or gender differences. Pediatric radiologists had significantly higher sensitivity compared to general radiologists, 88% and 71%, respectively ( < 0.01), but no differences were seen for specificity, PPV, and NPV. The sensitivity, NPV, and negative likelihood ratio for the combination of negative US, PAS < 5, and CRP < 5 mg/L were 98%, 98%, and 0.05 (95% CI 0.03-0.15). . US may be a useful tool for evaluating children with suspected appendicitis, regardless of age or gender, and should be the first choice of imaging modalities. Combining US with PAS and CRP may reduce several unnecessary admissions for in-hospital observation.
评估超声在小儿阑尾炎中的表现以及超声与小儿阑尾炎评分（PAS）和C反应蛋白（CRP）的联合应用。对2012年至2015年在一家三级儿科手术中心因疑似阑尾炎接受腹部超声检查的儿童进行一项基于机构的回顾性研究。超声结果分为两类，未显示阑尾视为检查阴性。总共纳入438名儿童（平均8.5岁，54%为男孩），阑尾炎发生率为29%。超声的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为82%、97%、92%和93%，无显著年龄或性别差异。儿科放射科医生的敏感性显著高于普通放射科医生，分别为88%和71%（<0.01），但在特异性、PPV和NPV方面无差异。超声阴性、PAS<5和CRP<5mg/L联合应用的敏感性、NPV和阴性似然比分别为98%、98%和0.05（95%CI 0.03 - 0.15）。超声可能是评估疑似阑尾炎儿童的有用工具，无论年龄或性别如何，应作为首选的影像学检查方法。将超声与PAS和CRP联合应用可减少数例不必要的住院观察入院。
