Journal of Hebei Medical University

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Clinical value of two scoring systems combined with high frequency color Doppler ultrasound in the diagnosis of acute appendicitis in children#br#

  

  1. 1.Department of Ultrasound, the Forth People′s Hospital in Nanchong City, Sichuan Province,
    6370002, China; 2.Department of Ultrasound, the Central Hospital in Nanchong City,
    Sichuan Province, 637000, China
  • Online:2017-10-25 Published:2017-10-18

Abstract: [Abstract] Objective〖HTSS〗〓To investigate the value of pediatric appendicitis score(PAS) and alvarado score system combined with high frequency color doppler ultrasonography for clinical diagnosis of children's acute appendicitis.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Two hundred and fifty  cases of children with abdominal pain were accepted the examination of high frequency color ultrasonography and were tested with pediatric appendicitis score and alvarado score system after admission, and then were checked with pathological diagnosis after appendectomy. The sensitivity and specificity of 2 scoring systems combined with high frequency color doppler ultrasound for diagnosis of acute appendicitis in children were analyzed by ROC curve.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓 Histopathological examination revealed 234 cases of acute purulent appendicitis(234/250, 93.6%) and 16 patients with acute simple appendicitis(16/250, 6.4%). The incidence of acute appendicitis by Alvarado and PAS scores was statistically significant among the lowrisk group, the middle risk group and the highrisk group(P>0.05). The critical diagnostic threshold for acute appendicitis was 6 points for the Alvarado and PAS scores. The sensitivity and specificity of Alvarado and PAS scoring in the diagnosis of acute appendicitis were 73.5% and 81.3%, 77.4% and 87.5% respectively. The sensitivity of combined with high frequency ultrasonography of acute appendicitis two scoring system(99.6%) was significantly higher than that of Alvarado score combined with high frequency ultrasound(82.1%)(χ2=6.327, P=0.020), PAS score combined with high frequency ultrasound(85.0%)(χ2=34.791, P=0.000). 
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The alvarado and PAS scoring system are valuable for the diagnosis of acute appendicitis in children, but the efficiency of 2 score combined with high frequency ultrasound diagnostic is better than a single scoring system or single scoring system combined with high frequency color doppler ultrasonography, which can improve the sensitivity and specificity of the diagnosis of children's acute appendicitis, and is worthy of clinical use.

Key words: appendicitis, scoring system, ultrasonography, children