Accuracy of ultrasound in the diagnosis of appendicitis

Abstract

OBJECTIVE: To verify the accuracy of ultrasonography in the context of medical emergency to evaluate patients with suspected acute appendicitis. MATERIALS AND METHODS: We performed a search in the PubMed database with the following keywords: ultrasound and appendicitis, prioritizing those that specifically addressed the diagnosis of appendicitis in young adult and aged patients. Of the 149 recovered, we excluded 126 after reading the titles. From the remaining twenty-three read in full, we discarded 16 for the reason that they did not address the age groups under analysis. After reading the remaining seven articles, we searched the references in these articles and included a further nine. Of these nine articles, four more references were selected and included in the analysis. RESULTS: The mean sensitivity was 81% (65-100%), and for specificity, the mean was 85% (67-98%). Of the studies that presented positive predictive value, the mean was 92%. In contrast, the negative predictive value was 57%. Considering the studies that compared ultrasonography performed by radiologists versus emergency physicians, one verified a better diagnostic accuracy in favor of radiologists, however without significant difference. CONCLUSION: Ultrasonography accuracy ranged from 70 a 92% and may reduce the rates of negative appendectomy