Accuracyof Ultrasound and CT Scans in the Diagnosis of Acute Appendicitis in Children: A Systematic Review
DOI:
https://doi.org/10.56570/jimgs.v1i1.153Keywords:
Precision medicine, personalized medicine, pharmacogenomics testing, individualized medicine, predictive medicine and Antidepressant DrugAbstract
Acute appendicitis (AA) is the most common surgical emergency in childhood. Accurate and early diagnosis is important because any delay in diagnosis may lead to perforation or abscess formation. Today, abdominal ultrasonography (US) and computed tomography (CT) scans are the most common imaging methods used for diagnosis. The aim of this study was to evaluate the accuracy of US and CT scans in the diagnosis of AA in children. We started our research by using online libraries as our database. We searched PubMed, Google Scholar, the Cochrane Library, and the Web of Science for our data collection. We used both the medical subject headings (MESH) and regular keywords. Our review investigated English-language articles regarding the accuracy of US and CT scans in the diagnosis of AA in children (2013-2023) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Articles were screened by title, abstract, inclusion and exclusion criteria, and quality assessment tools. The search identified 513 studies; eight were eligible for inclusion in the analysis. A total of 3341 pediatric patients were included across the eight observational studies in our systematic reviews. The included articles revealed that low-dose CT showed the highest accuracy in the diagnosis of AA. Whereas the US showed the lowest. However, the combination of US as the primary examination followed by CT in a non-diagnostic US yielded the highest sensitivity, specificity, and accuracy. Also, some studies revealed that several factors decreased the sensitivity of CT and US in diagnosing AA in children, like different hospital settings, the radiologist's experience, age, sex, body mass index, and disease severity. According to the review articles, a CT scan is the most accurate test and has high sensitivity and specificity; however, the radiation hazards are minimized using a CT scan as a primary tool for diagnosis. US is easily accessible, cost-effective, and has high sensitivity. However, it is operator-dependent, has low specificity, and is incompatible with some young children, so it can be used as a first-choice and low-dose CT scan in complicated cases and non-diagnostic US. Ideally, more randomized clinical trials are also required.References
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