Improvement in diagnostic accuracy of ultrasound of the pediatric appendix through the use of equivocal interpretive categories

AJR. American Journal of Roentgenology
David B LarsonAlexander J Towbin

Abstract

The purpose of this article is to evaluate the diagnostic performance of ultrasound of the pediatric appendix using standardized structured reports that incorporate equivocal interpretive categories. Standardized structured appendix ultrasound reports using a five-category interpretive scheme were reviewed. Interpretive categories were positive, intermediate likelihood, or negative when the appendix was visualized, and secondary signs or no secondary signs when the appendix was not visualized. Interpretations were compared with clinical and pathologic follow-up. Diagnostic accuracy was compared with the accuracy of a simulated binary interpretive scheme based on the same data. One thousand three hundred fifty-seven examinations were included, with appendicitis present in 16.9% (230/1357) of cases. The appendix was visualized in 47.2% (641/1357) of cases, with interpretations as follows: positive, 27.5% (176/641); intermediate likelihood, 9.7% (62/641); and normal, 62.9% (403/641). The appendicitis rate in each group was 92.6% (163/176), 25.8% (16/62), and 0.5% (2/403), respectively. The appendix was not visualized in 52.8% (716/1357) of cases, with secondary findings identified in 8.5% (61/716) and no secondary findings in 91.5...Continue Reading

References

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Citations

Aug 19, 2015·Pediatric Radiology·Larry A BinkovitzJames L Homme
Aug 19, 2015·Pediatric Radiology·Andrew T Trout, David B Larson
Apr 5, 2016·Radiología·D Coca RobinotE Aguirre Pascual
Oct 18, 2016·The American Journal of Emergency Medicine·Holly DepinetUNKNOWN APAB Study Group
Feb 18, 2016·Insights Into Imaging·Gerhard MostbeckCatherine M Owens
Aug 15, 2018·AJR. American Journal of Roentgenology·David W SwensonEdward Y Lee
Mar 30, 2019·Pediatric Radiology·Lindsey A G Shea, Alexander J Towbin
Aug 6, 2017·Pediatric Radiology·Preetam Gongidi, Richard D Bellah
May 26, 2017·Pediatric Radiology·Alexander J TowbinDavid B Larson
Feb 19, 2019·Radiology·Jonathan R Dillman, Andrew T Trout
Aug 13, 2021·European Radiology·Eric L TungDavid W Swenson

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