Appendiceal sonography in children: A retrospective analysis as a platform for potential implementation of diagnostic categories

Reddan, Tristan, Corness, Jonathan, Mengersen, Kerrie, & Harden, Fiona (2016) Appendiceal sonography in children: A retrospective analysis as a platform for potential implementation of diagnostic categories. In 23rd Annual International Conference of the Australasian Sonographers Association, 13-15 May 2016, Melbourne, Vic.

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Abstract

  • Background

Sonography is an important diagnostic tool in children with suspected appendicitis. Reported accuracy and appendiceal visualisation rates vary significantly, as does the management of equivocal ultrasound findings. The aim of this study was to audit appendiceal sonography at a tertiary children's hospital, and provide baseline data for a future prospective study.

  • Summary of work

Records of children who underwent ultrasound studies for possible appendicitis between January 2008 and December 2010 were reviewed. Variables included patient demographics, sonographic appendix characteristics, and secondary signs. Descriptive statistics and analysis using ANOVA, Mann-Whitney U test, and ROC curves were performed. Mater Human Research Ethic Committee approval was granted.

  • Summary of results

There were 457 eligible children. Using a dichotomous diagnostic model (including equivocal results), sensitivity was 89.6%, specificity 91.6%, and diagnostic yield of 40.7%. ROC curve analysis of a 6mm diameter cut-off was 0.88 AUC (95% CI 0.80 to 0.95).

  • Discussion and conclusions

Sonography is an accurate test for acute appendicitis in children, with a high sensitivity and negative predictive value. A diameter of 6mm as an absolute cut-off in a binary model can lead to false findings. Results were compared with available literature. Recent publications propose categorising diameter1 and integrating secondary signs2 to improve accuracy and provide more meaningful results to clinicians. This study will be a benchmark for future studies with multiple diagnostic categorisation.

Impact and interest:

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ID Code: 95574
Item Type: Conference Item (Other)
Refereed: Yes
Additional URLs:
Keywords: ultrasound, appendicitis, paediatrics
DOI: 10.1002/sono.12058
ISSN: 2054-6750
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Radiology and Organ Imaging (110320)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PAEDIATRICS AND REPRODUCTIVE MEDICINE (111400) > Paediatrics (111403)
Divisions: Current > Research Centres > ARC Centre of Excellence for Mathematical & Statistical Frontiers (ACEMS)
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Mathematical Sciences
Current > QUT Faculties and Divisions > Science & Engineering Faculty
Deposited On: 16 May 2016 00:52
Last Modified: 16 May 2016 00:52

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