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©2013 UpToDate ® Print Email Sensitivity and specificity of ultrasonography in the detection of acute appendicitis Number of patients Sensitivity Specificity PPV NPV Study Author Year 70 94 89 89 94 [1] Vignault F, et al 1990 857 90 98 94 97 [2] Schwerk WB, et al 1990 462 77 NE >92 NE [3] Bendeck SE, et al 2002 283 86 95 91 92 [4] Kaiser S, et al 2002 49* 84 96 90 NE [5] Sun SS, et al 2002 40 87 90 NE NE [6] Chang CC, et al 2003 199 79 78 87 65 [7] Poortman P, et al 2003 174 100 37 50 100 [8] Rettenbacher T, et al 2003 125 83 95 NE NE [9] Kessler N, et al 2004 174 83 95 86 94 [10] Chan I, et al 2005 MA • 88 94 NE NE [11] Doria AS, et al 2006 MA Δ 83 93 NE NE [11] Doria AS, et al 2006 MA ◊ 87 89 NE NE [12] Klein MD 2007 420 74 97 88 93 [13] Gaitini D, et al 2008 132 65 90 84 76 [14] Fox JC, et al 2008 33 § 50 100 100 66 [15] Israel GM, et al 2008 121 ¥ 90 93 NE NE [16] Je BK, et al 2009 121 ������ 85 96 NE NE [16] Je BK, et al 2009 162 ������ 87 46 49 85 [17] Schuh S, et al 2010 193 81 88 61 95 [18] Pacharn P, et al 2010 204 ������ 99 95 NE NE [19] Goldin AB, et al 2011 147 ������ 38 97 NE NE [20] Abo A, et al 2011 PPV: positive predictive value; NPV: negative predictive value; NE: not evaluable. * Age >50 years old. • Meta-analysis in children, 26 studies, 9356 patients. Δ Meta-analysis in adults, 31 studies, 4341 patients. ◊ Meta-analysis, 9 studies. § Pregnant women. ¥ Criterion is the maximal-outer-diameter (MOD) >0.57 mm. ������ Criterion is the maximal-mural-thickness (MMT) >0.22 mm. ������ Children. References: Vignault F, Filiatrault D, Brandt ML, Garel L, Grignon A, Ouimet A. Acute appendicitis in children: evaluation with US. Radiology 1990; 176:501. Schwerk WB, Wichtrup B, Ruschoff J, Rothmund M. Acute and perforated appendicitis: current experience with ultrasound-aided diagnosis. World J Surg 1990; 14:271. Bendeck SE, Nino-Murcia M, Berry GJ, Jeffrey RB, Jr. Imaging for suspected appendicitis: negative appendectomy and perforation rates. Radiology 2002; 225:131. Kaiser S, Frenckner B, Jorulf HK. Suspected appendicitis in children: US and CT--a prospective randomized study. Radiology 2002; 223:633. Sun SS, Wu HS, Wang JJ, Ho ST, Kao A. Comparison between technetium 99m hexamethylpropyleneamine oxide labeled white blood cell abdominal scan and abdominal sonography to detect appendicitis in adult patients with atypical clinical presentation. Abdom Imaging 2002; 27:734.

Kaiser S, Frenckner B, Jorulf HK. Suspected appendicitis in children: US and CT--a prospective randomized study. Radiology 2002; 223:633. Sun SS, Wu HS, Wang JJ, Ho ST, Kao A. Comparison between technetium 99m hexamethylpropyleneamine oxide labeled white blood cell abdominal scan and abdominal sonography to detect appendicitis in adult patients with atypical clinical presentation. Abdom Imaging 2002; 27:734. Chang CC, Tsai CY, Lin CC, Jeng LB, Lee CC, Kao CH. Comparison between technetium-99m hexamethylpropyleneamineoxide labeled white blood cell abdomen scan and abdominal sonography to detect appendicitis in children with an atypical clinical presentation. Hepatogastroenterology 2003; 50:426. Poortman P, Lohle PN, Schoemaker CM, Oostvogel HJ, Teepen HJ, Zwinderman KA et al. Comparison of CT and sonography in the diagnosis of acute appendicitis: a blinded prospective study. AJR Am J Roentgenol 2003; 181:1355. Rettenbacher T, Hollerweger A, Macheiner P, Gritzmann N, Daniaux M, Schwamberger K et al. Ovoid shape of the vermiform appendix: a criterion to exclude acute appendicitis--evaluation with US. Radiology 2003; 226:95. Kessler N, Cyteval C, Gallix B, Lesnik A, Blayac PM, Pujol J et al. Appendicitis: evaluation of sensitivity, specificity, and predictive values of US, Doppler US, and laboratory findings. Radiology 2004; 230:472. Chan I, Bicknell SG, Graham M. Utility and diagnostic accuracy of sonography in detecting appendicitis in a community hospital. AJR Am J Roentgenol 2005; 184:1809. Doria AS, Moineddin R, Kellenberger CJ, Epelman M, Beyene J, Schuh S et al. US or CT for Diagnosis of Appendicitis in Children and Adults? A Meta-Analysis. Radiology 2006; 241:83. Klein MD. Clinical approach to a child with abdominal pain who might have appendicitis. Pediatr Radiol 2007; 37:11. Gaitini D, Beck-Razi N, Mor-Yosef D, Fischer D, Ben Itzhak O, Krausz MM, Engel A. Diagnosing acute appendicitis in adults: accuracy of color Doppler sonography and MDCT compared with surgery and clinical follow-up. AJR Am J Roentgenol. 2008; 190:1300. Fox JC, Solley M, Anderson CL, Zlidenny A, Lahham S, Maasumi K. Prospective evaluation of emergency physician performed bedside ultrasound to detect acute appendicitis. Eur J Emerg Med. 2008; 15:80. Israel GM, Malguria N, McCarthy S, Copel J, Weinreb J. MRI vs. ultrasound for suspected appendicitis during pregnancy. J Magn Reson Imaging. 2008; 28:428.

Fox JC, Solley M, Anderson CL, Zlidenny A, Lahham S, Maasumi K. Prospective evaluation of emergency physician performed bedside ultrasound to detect acute appendicitis. Eur J Emerg Med. 2008; 15:80. Israel GM, Malguria N, McCarthy S, Copel J, Weinreb J. MRI vs. ultrasound for suspected appendicitis during pregnancy. J Magn Reson Imaging. 2008; 28:428. Je BK, Kim SB, Lee SH, Lee KY, Cha SH. Diagnostic value of maximal-outer-diameter and maximal-mural-thickness in use of ultrasound for acute appendicitis in children. World J Gastroenterol. 2009; 15:2900. Schuh S, Man C, Cheng A, Murphy A, Mohanta A, Moineddin R, Tomlinson G, Langer JC, Doria AS. Predictors of non-diagnostic ultrasound scanning in children with suspected appendicitis. J Pediatr. 2011; 158:112. Pacharn P, Ying J, Linam LE, Brody AS, Babcock DS. Sonography in the evaluation of acute appendicitis: are negative sonographic findings good enough? J Ultrasound Med. 2010; 29:1749. Goldin AB, Khanna P, Thapa M, McBroom JA, Garrison MM, Parisi MT. Revised ultrasound criteria for appendicitis in children improve diagnostic accuracy. Pediatr Radiol. 2011; 41:993. Abo A, Shannon M, Taylor G, Bachur R. The influence of body mass index on the accuracy of ultrasound and computed tomography in diagnosing appendicitis in children. Pediatr Emerg Care. 2011; 27:731.