Ultrasound proves true in pediatric appendicitis

In many institutions, children with suspected appendicitis head straight to the CT scanner for evaluation. But ultrasound provides an alternative, accurate means of making an initial diagnosis, sparing many children from potentially harmful radiation exposure, according to a study presented at the RSNA meeting.

In the retrospective study of 129 patients with suspected appendicitis, ultrasound as the primary imaging modality accurately identified positive cases and spared 45% of patients from CT radiation exposure, said Shlomit Goldberg, a medical student at Stanford University who presented the results.

Ultrasound has a high positive predictive value in pediatric appendicitis and can be relied upon to identify patients who need surgery. But it also has a high false-negative rate. At Stanford, ultrasound is the primary imaging modality for pediatric appendicitis, and positive cases are sent to the operating room for surgery. Indeterminate or negative ultrasound studies are followed up with CT.