소아 급성 충수염에서 복부초음파 이후 전산화단층촬영 추적 검사의 임상적 의의
Clinical Significance of Follow-up CT after Ultrasonography for Acute Appendicitis in Children
유성근, 허태길, 이종국, 문진수, 황종희, 남승연, 김동욱, 김남희, 서정욱,
소속 상세정보
유성근 ( Yu Seong-Keun )
인제대학교 의과대학 일산백병원 소아과학교실
허태길 ( Heo Tae-Kil )
인제대학교 의과대학 외과학교실
이종국 ( Lee Jong-Guk )
인제대학교 의과대학 일산백병원 소아과학교실
문진수 ( Moon Jin-Soo )
인제대학교 의과대학 일산백병원 소아과학교실
황종희 ( Hwang Jong-Hee )
인제대학교 의과대학 일산백병원 소아과학교실
남승연 ( Nam Seung-Yeun )
인제대학교 의과대학 일산백병원 소아과학교실
김동욱 ( Kim Dong-Wook )
인제대학교 의과대학 일산백병원 소아과학교실
김남희 ( Kim Nam-Hee )
인제대학교 의과대학 일산백병원 소아과학교실
서정욱 ( Seo Jung-Wook )
인제대학교 의과대학 영상의학교실
KMID : 0816120070100010036
Abstract
Purpose: The ultrasonography (USG) and computed tomography (CT) are popular diagnostic tools for the diagnosis of acute appendicitis in children, but there are many debates about their clinical significance. The purpose of this study is to clarify the clinical significance of USG, CT and follow-up CT performed subsequently to USG, especially in perforated acute appendicitis in children.
Methods: We have reviewed 419 cases of surgically confirmed acute appendicitis in children under the age of sixteen, who had been treated in Inje University Ilsan Paik Hospital from March 2002 to February 2006. All the clinical data including the results of USG and CT were collected and analyzed.
Results: Sensitivity, specificity, positive and negative predictive values of USG were 98.7%, 96.8%, 98.1%, 97.8% in non-perforation group and 90.8%, 100%, 100%, 81.9% in perforation group. Those of CT were 96.4%, 100%, 100%, 96.5% and 86.6%, 100%, 100%, 87.5% respectively. Those of follow-up CT after USG were 100%, 100%, 100%, 100% and 87.5%, 100%, 100%, 92.0% respectively. The duration of using antibiotics in seven patients showed positive correlation with the interval between two imaging studies (r=0.0472, p=0.019). There was no statistical significance of correlation when these imaging studies performed within 30 hours together.
Conclusion: In most of the cases, single choice between USG and CT would be enough to diagnose the acute appendicitis in children. But, it may be helpful to perform CT as early as possible subsequently to USG when there is discrepancy between initial USG and clinical impression.
키워드
Appendicitis;Perforation;Children;Ultrasonography;Computed tomography
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