Revaluation of sonographic criteria of acute appendicitis in children

Transcription

1 Revaluation of sonographic criteria of acute appendicitis in children Poster No.: C-1615 Congress: ECR 2011 Type: Scientific Exhibit Authors: A. Alvarez Vazquez, N. Fernandez Garcia, G. Anes, C. J Quispe, S. C. G. Costilla, P. Sanchez Lopez, P. Redondo Buil, N. Sanchez, A. M. Benitez Vazquez ; Aviles/ES, Oviedo/ES, 3 Gijon/ES Keywords: Inflammation, Acute, Diagnostic procedure, Ultrasound, Paediatric, Emergency, Abdomen DOI: /ecr2011/C-1615 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 45

2 Purpose Evaluate classic sonographic criteria of acute appendicitis in children. Since we have seen enlarged appendices in sane children without abdominal sypmtoms, our main purpose is to establish the cutoff point of appendix diameter for acute appendicitis. In addition, we want to set the wall thickness as sonographic criteria, calculating its normal and pathologic values. Page 2 of 45

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16 Methods and Materials We analyze retrospectively the ultrasonographic features of 29 cases appendectomy by the pediatric surgery department of the "Hospital Universitario Central de Asturias (HUCA)" between January 1, 2008 and Dec. 31, And we compared with the ultrasound characteristics of 29 children who attended the Radiology service of HUCA for another patology, without abdominal symptoms. Page 16 of 45

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28 Results With statistical analysis using ROC curves we obtained a value of 6.8 for the diameter of the appendix with a sensitivity of 96% and specificity of 89%. The value for the wall thickness was 2.94, with a sensitivity of 91% and specificity of 89%. If we associate the two criteria, using a mathematical formula, we obtain a value with a cutoff point with a sensitivity and a specificity of 91%. Page 28 of 45

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39 Conclusion We can consider pathological appendages those with a diameter greater than 6.8 mm. Can be considered as a diagnostic complement the thickness of the wall of the appendix, located its breakpoint at 2.95 mm. In order to increase accuracy, you can combine the two parameters, using the mathematical formula: score =7 wall thickness +2 diameter, with a cutoff of Page 39 of 45

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44 References 1. Rioux M. Sonographic detection of the normal and abnormal appendix. Am J Roentgenorl 1992;158: Ida Chan, Simon G. Bicknell, Mary Graham. Utility and Diagnostic Accuracy of Sonography in Detecting Appendicitis in a Community Hospital. Ajr 2005; 184: Sivit CJ, Siegel MJ, Applegate KE, Newman KD. When appendicitis is suspected in children. RadioGraphics 2001; 21: Del Cura Jl, Oleaga L, Grand D. Indicaciones de las técnicas de diagnóstico por la imagen en la sospecha de apendicitis aguda: propuesta de protocolo diagnóstico. Radiología 2001;43: Siegel MJ. Pediatric sonography, 2nd ed. Marbán Rebeca Pintado Garrido, Marta Moya De la Calle, Susana Sánchez Ramón, Miguel Ángel Castro Villamor, Sara Plaza Mora, Marcelino Mendo González. Indicación y utilidad de la ecografía urgente en la sospecha de apendicitis aguda. Emergencias 2008; 20: Adriana B. Peletti, Matteo Baldisserotto. Optimizing US examination to detect the normal and abnormal appendix in children. Pediatr Radiol, 2006; 36: Sivit, Carlos J. Diagnosis of Acute Appendicitis in Children: Spectrum of Sonographic Findings. AJR 1993;161 : Page 44 of 45

45 Personal Information Page 45 of 45