Ultrasound first, not CT, for appendicitis
Published: May 8, 2008 at 3:52 PM
HAIFA, Israel, May 8 (UPI) -- Color Doppler ultrasound, not computed tomography, or CT, should be the first test for adults with suspected acute appendicitis, an Israeli study said.
The study of 420 medical records found that sonography, or ultrasound, correctly denied acute appendicitis in 303 of 312 adult patients, meaning it had a 97 percent specificity rate, said Dr. Diana Gaitini, of Rambam Health Care Campus in Haifa, Israel.
"When the patient does not have acute appendicitis, the negative result of the color Doppler ultrasound examination is highly confident," Gaitini said in a statement. On the other hand, ultrasound's sensitivity rate was 74 percent meaning it missed the diagnosis in 23 of 89 patients, Gaitini said.
The study, published in the American Journal of Roentgenology, said the CT correctly diagnosed acute appendicitis in 38 of 39 patients -- 99 percent sensitivity rate -- and correctly denied acute appendicitis in all 92 patients -- a 100 percent specificity rate. CT was inconclusive in one patient.
"CT has a slightly higher specificity rate and a higher sensitivity rate than ultrasound, but ultrasound can help the radiologist make a definitive diagnosis in most patients," Gaitini said. "Lack of radiation exposure, higher availability, lower cost and high specificity of color Doppler ultrasound are the main reasons for trying ultrasound first."
The study of 420 medical records found that sonography, or ultrasound, correctly denied acute appendicitis in 303 of 312 adult patients, meaning it had a 97 percent specificity rate, said Dr. Diana Gaitini, of Rambam Health Care Campus in Haifa, Israel.
"When the patient does not have acute appendicitis, the negative result of the color Doppler ultrasound examination is highly confident," Gaitini said in a statement. On the other hand, ultrasound's sensitivity rate was 74 percent meaning it missed the diagnosis in 23 of 89 patients, Gaitini said.
The study, published in the American Journal of Roentgenology, said the CT correctly diagnosed acute appendicitis in 38 of 39 patients -- 99 percent sensitivity rate -- and correctly denied acute appendicitis in all 92 patients -- a 100 percent specificity rate. CT was inconclusive in one patient.
"CT has a slightly higher specificity rate and a higher sensitivity rate than ultrasound, but ultrasound can help the radiologist make a definitive diagnosis in most patients," Gaitini said. "Lack of radiation exposure, higher availability, lower cost and high specificity of color Doppler ultrasound are the main reasons for trying ultrasound first."
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