Wong M L, Casey S O, Leonidas J C, Elkowitz S S, Becker J
Department of Radiology, Schneider Children's Hospital, New Hyde Park, NY 11042.
J Pediatr Surg. 1994 Oct;29(10):1356-60. doi: 10.1016/0022-3468(94)90115-5.
The authors performed graded compression abdominal ultrasound (US) examinations in children with suspected acute appendicitis, whose clinical presentation was atypical. Abdominal US examination results were 95% accurate, far exceeding that reported for other imaging modalities. The sensitivity was 86%, the specificity was 98%, and the positive and negative predictive values were 96% and 94%, respectively. A positive sonogram made the likelihood of acute appendicitis 50 times greater compared with the pretest clinical impression. In addition, the use of US permitted identification of other pathological conditions that manifest similar symptoms and signs. The authors conclude that, with proper experience, US can be extremely useful in assisting the surgeon to markedly decrease the number of unnecessary appendectomy procedures, without increasing the risk of perforation.
作者对临床表现不典型、疑似急性阑尾炎的儿童进行了分级加压腹部超声（US）检查。腹部超声检查结果的准确率为95%，远高于其他成像方式的报告准确率。敏感性为86%，特异性为98%，阳性和阴性预测值分别为96%和94%。与检查前的临床印象相比，超声检查阳性使急性阑尾炎的可能性增加了50倍。此外，使用超声可以识别表现出类似症状和体征的其他病理状况。作者得出结论，凭借适当的经验，超声在协助外科医生显著减少不必要的阑尾切除手术数量方面极为有用，同时不会增加穿孔风险。
