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An audit to evaluate the Diagnostic Sensitivity of Computed Tomography and Ultrasound in suspected Acute Appendicitis
EP30645
Poster Title: An audit to evaluate the Diagnostic Sensitivity of Computed Tomography and Ultrasound in suspected Acute Appendicitis
Submitted on 25 Sep 2019
Author(s): Omed Amin, Karen Duncan
Affiliations: Aberdeen Royal Infirmary
This poster was presented at BIR Annual Congress 2019
Poster Views: 423
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Poster Information
Abstract: Introduction

According to recent studies, computed tomography (CT) demonstrates desirable accuracy in detecting acute appendicitis, while appreciably reducing the negative appendicectomy rate. Ultrasound (US) imaging is preferred as a first-line imaging in children/young adults and women of child-bearing age.

Aim

We have audited the degree of clinicopathological correlation between the pre-appendicectomy CT and US reports and the histopathology results at our institution.

Methods

Data on histopathology samples submitted over a 6 months period were collected followed by a review of pre-operative imaging reports.

Results

For CT, the sensitivity should exceed 90%. The target was met (96%).
For US, the sensitivity should exceed 70% while the sensitivity value in the paediatric subgroup should be 85% or higher: The target was not met either overall (49%) or in the paediatric subgroup (78%).

Conclusion

Our audit reveals that the diagnostic accuracy of CT in detecting appendicitis is comparable with the data in the published literature. The results for Ultrasound are falling short, both overall and in the paediatric subgroup. We evaluated why our Ultrasound data needs to be interpreted with caution and propose a way to improve the sensitivity of US at our institution.
Summary: Acute Appendicitis is an important clinical entity across all age groups and we have investigated the diagnostic sensitivity of CT and US, while comparing the negative appendicectomy rate with patients who proceeded to surgery without pre=op imaging. References: 1.Eng, K., Abadeh, A., Ligocki, C., Lee, Y., Moineddin, R., Adams-Webber, T., Schuh, S. and Doria, A. (2018). Acute Appendicitis: A Meta-Analysis of the Diagnostic Accuracy of US, CT, and MRI as Second-Line Imaging Tests after an Initial US. Radiology, 288(3), pp.717-727.

2.Collins G, Bhogal P, Tan A. Assessing the Quality of CT Reporting in Suspected Appendicitis | The Royal College of Radiologists. Rcr.ac.uk.
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