Systematic Review: Computed Tomography and Ultrasonography To Detect Acute Appendicitis in Adults and Adolescents

@article{Terasawa2004SystematicRC,
  title={Systematic Review: Computed Tomography and Ultrasonography To Detect Acute Appendicitis in Adults and Adolescents},
  author={Teruhiko Terasawa and Craig Blackmore and Stephen Bent and R. Jeffrey Kohlwes},
  journal={Annals of Internal Medicine},
  year={2004},
  volume={141},
  pages={537-546}
}
Context Is computed tomography or ultrasonography better for diagnosing acute appendicitis? Contribution This meta-analysis summarized data from 22 prospective studies that compared results of computed tomography, ultrasonography, or both with surgical findings or clinical follow-up in patients with suspected appendicitis. Computed tomography findings (positive likelihood ratio, 13.3 [95% CI, 9.9 to 17.9]) increased the certainty of diagnosis more than did ultrasonography (positive likelihood… Expand
Diagnosis of appendicitis in adults by ultrasonography or computed tomography: A systematic review and meta-analysis
TLDR
Meta-analysis of eligible studies shows CT to have better sensitivity and specificity than ultrasound in both clinical situations and application in clinical practice and policy would need to evaluate the better diagnostic performance of CT against its cost and availability. Expand
Routine Ultrasound and Limited Computed Tomography for the Diagnosis of Acute Appendicitis
TLDR
A diagnostic pathway using routine US, limited CT, and clinical re-evaluation for patients with acute abdominal pain can provide excellent results for the diagnosis and treatment of appendicitis. Expand
Computed tomography for diagnosis of acute appendicitis in adults.
TLDR
The accuracy of CT for diagnosing appendicitis in adults with suspected appendicectomy was evaluated according to the Quality Assessment of Studies of Diagnostic Accuracy - Revised (QUADAS-2) tool and results show practically no differences in summary specificity. Expand
Suspicion of acute appendicitis in adults. The value of ultrasound in our hospital
TLDR
Ultrasound is very accurate for the diagnosis of acute appendicitis in adults, and the negative appendicectomy rate in operated patients and the accuracy of pre-defined diagnostic categories are calculated. Expand
An international evaluation of ultrasound vs. computed tomography in the diagnosis of appendicitis
TLDR
Radiologist-operated US had inferior sensitivity and positive predictive value when compared with CT, though was significantly faster to perform, and avoided radiation and contrast in a majority of patients. Expand
Accuracy of ultrasonography in diagnosing acute appendicitis during pregnancy based on surgical findings
TLDR
Ulasonography is the initially preferred imaging modality in pregnant women suspected of having acute appendicitis with an acceptable sensitivity; however, application of other imaging modalities such as CT scan or MRI is recommended after inconclusive ultrasonography results. Expand
US or CT for Diagnosis of Appendicitis in Children and Adults? A Meta-Analysis.
TLDR
CT had a significantly higher sensitivity than did US in studies of children and adults; from the safety perspective, however, one should consider the radiation associated with CT, especially in children. Expand
Acute appendicitis: meta-analysis of diagnostic performance of CT and graded compression US related to prevalence of disease.
PURPOSE This study was a head-to-head comparison of graded compression ultrasonography (US) and computed tomography (CT) in helping diagnose acute appendicitis with an emphasis on diagnostic value atExpand
Diagnostic Performance of Multidetector Computed Tomography for Suspected Acute Appendicitis
TLDR
Multidetector computed tomography is a useful test for routine evaluation of suspected appendicitis in adults, according to the reference standard of final combined clinical, surgical, and pathology findings. Expand
Ultrasonography/MRI Versus CT for Diagnosing Appendicitis
TLDR
In children with suspected acute appendicitis, a radiation-free diagnostic imaging of ultrasonography selectively followed by MRI is feasible and comparable to CT, with no difference in time to antibiotic administration, time to appendectomy, negative appendectomy rate, perforation rate, or length of stay. Expand
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References

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TLDR
A subset of patients presenting with possible acute appendicitis has been identified that should benefit from imaging of the appendix prior to surgical consultation, and CT scan appears superior to abdominal and pelvic US in terms of diagnostic accuracy and reliability. Expand
Suspected acute appendicitis: is ultrasonography or computed tomography the preferred imaging technique?
TLDR
CT is more sensitive and specific than US in patients suspected of having acute appendicitis, but in whom the presentation is equivocal, and the use of unenhanced spiral CT led to a significant improvement in the accuracy of preoperative diagnosis and a lower negative appendicectomy rate. Expand
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TLDR
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TLDR
Ultrasonography may significantly improve the diagnostic accuracy in patients with suspected acute appendicitis and should be performed in all patients in whom the clinical diagnosis is equivocal. Expand
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TLDR
The use of spiral computed tomography in patients with equivocal clinical presentation suspected of having acute appendicitis led to a significant improvement in the preoperative diagnosis and a lower negative appendectomy rate. Expand
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TLDR
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TLDR
It is concluded that ultrasonography is a useful aid in the diagnosis of appendicitis, which resulted in changes in the proposed management in 29 of the 111 patients and led to the correct diagnosis in the 16 patients who were found to have a disease other than appendix. Expand
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TLDR
It is concluded that although adjunctive testing may be beneficial in selected patients, its routine use in patients suspected of having appendicitis cannot be advocated at present. Expand
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TLDR
In 17 of 31 patients without CT evidence of appendicitis, other conditions explaining their symptoms were detected, and when the clinical diagnosis is in doubt, CT can be used successfully to evaluate patients with acute appendiciti. Expand
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