CT scans may not reduce the negative appendectomy rate in children
CT scans may not reduce the negative appendectomy rate in children
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DOI：
10.1016/j.jpedsurg.2004.02.034
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发表时间：
2004-06-01
影响因子：
2.4
通讯作者：
Caniano, DA
中科院分区：
文献类型：
--
作者：
Martin, AE;Vollman, D;Caniano, DA
背景/目的：考虑到接受过单次计算机断层扫描（CT）的儿童一生中患癌症的风险增加，我们回顾了该诊断测试在阑尾炎人群中的应用。方法：回顾性分析我院1998 ~ 2001年诊断为阑尾炎的720例患儿的辅助诊断方法，包括超声和CT扫描。阴性阑尾切除率由最终病理报告确定。采用chi(2)检验进行统计学比较，P < 0.05为显著性。结果：阑尾炎的超声诊断率由1998年的20.0%下降到2001年的7.0% （P < 0.01）。相反，CT扫描的使用率从1998年的17.6%上升到2001年的51.3% （P < 0.001）。两组间阑尾切除术阴性率差异无统计学意义（P < 0.20）。在阴性阑尾切除术中，11例患者USG解释为阑尾炎阳性（22.0%），9例患者CT扫描解释为阳性（18.0%）。结论：CT扫描在儿童阑尾炎诊断中的自由应用并未导致阑尾切除术阴性率的降低。潜在的有害辐射暴露应促使儿科外科医生重新评估CT扫描在治疗疑似阑尾炎儿童中的作用。2004爱思唯尔公司版权所有。
Background/Purpose: Concern about an increased lifetime risk of cancer in children who have undergone a single computed tomography (CT) scan prompted us to review utilization of this diagnostic test in our appendicitis population.Methods: From 1998 to 2001, the records of 720 children admitted to our hospital with a diagnosis of appendicitis were reviewed for adjunct diagnostic modalities, including ultrasonography (USG) and CT scanning. Negative appendectomy rates were determined by the final pathologic report. Statistical comparisons were made using the chi(2) test, and significance was assigned at P < .05.Results: The use of ultrasound scan for diagnosing appendicitis decreased from 20.0% in 1998 to 7.0% in 2001 (P < .01). Conversely, the use of CT scans increased from 17.6% in 1998 to 51.3% in 2001 (P < .001). During this time period the difference in the negative appendectomy rate was not statistically significant (P < 0.20). Of the negative appendectomies, 11 of these patients had a USG interpreted as positive for appendicitis (22.0%), and 9 had a CT scan interpreted as positive (18.0%).Conclusions: Liberal use of CT scans in diagnosing appendicitis in children has not resulted in a decreased negative appendectomy rate. Potentially harmful radiation exposure should prompt pediatric surgeons to reevaluate the role of CT scanning in the management of children with suspected appendicitis. C 2004 Elsevier Inc. All rights reserved.