Diagnostic performance of US for suspected appendicitis: Does multi-categorical reporting provide better estimates of disease in adults, and what factors are associated with false or indeterminate results?

Alexander Froc, Candice Crocker, Mohamed Abdolell, Andreu F. Costa

Résultat de recherche: Articleexamen par les pairs

2 Citations (Scopus)

Résumé

Purpose: To identify factors associated with false or indeterminate US result for suspected appendicitis, and assess whether multi-categorical reporting of US yields more precise estimates regarding the probability of appendicitis. Methods: 562 US examinations for suspected appendicitis between May 2013-April 2015 were categorized as true (77/562 true positives or true negatives) or false/indeterminate (485/562 false negatives, false positives or indeterminates) based on results from a prior study. Of 541 examinations with images available retrospectively, a category of A–E was assigned as follows: non-visualized appendix with secondary findings (A) absent or (B) present; appendix visualized and considered (C) negative, (D) equivocal, or (E) positive for appendicitis. The following factors were recorded: age; sex; scan time (daytime vs. off-hours); resident/fellow involvement; abdominal subspecialty radiologist; radiologist experience (>5 years or not); and tenderness on interrogation. Associations between factors and US result were assessed (t-tests, Fisher's exact test and multivariate logistic regression). Results: The true group had proportionally more males (18/77 (23.4%) vs. 66/485 (13.6%), p = 0.04) and patients with sonographic tenderness (43/77 (55.8%) vs. 132/353 (27.3%), p < 0.0001). There was no significant difference or association with other factors. On multivariate logistic regression, false/indeterminate results were 1.9 times (95% CIs 1.0–3.5) more likely among females and 3.8 times more likely in the absence of tenderness (95% CIs 2.3–6.4). The proportion of patients with appendicitis in categories A-E was 34/410 (8.3%), 24/44 (54.5%), 0/18 (0%), 0/3 (0%) and 61/66 (92.4%), respectively. Conclusions: Females and absence of tenderness were associated with a false/indeterminate US. Categorical reporting provides more granular estimates of the post-test probability of appendicitis.

Langue d'origineEnglish
Numéro d'article109992
JournalEuropean Journal of Radiology
Volume144
DOI
Statut de publicationPublished - nov. 2021
Publié à l'externeOui

Note bibliographique

Funding Information:
The authors thank Dorrell Metcalfe for assistance with retrieval of imaging examinations, and J Byron Ramsey and M Kamali for assistance with data collection.

Publisher Copyright:
© 2021 Elsevier B.V.

ASJC Scopus Subject Areas

  • Radiology Nuclear Medicine and imaging

PubMed: MeSH publication types

  • Journal Article

Empreinte numérique

Plonger dans les sujets de recherche 'Diagnostic performance of US for suspected appendicitis: Does multi-categorical reporting provide better estimates of disease in adults, and what factors are associated with false or indeterminate results?'. Ensemble, ils forment une empreinte numérique unique.

Citer