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Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí hóa hoc quốc tế đề tài : An international evaluation of ultrasound vs. computed tomography in the diagnosis of appendicitis | Reich et al. International Journal of Emergency Medicine 2011 4 68 http www.intjem.eom content 4 1 68 o International Journal of Emergency Medicine a SpringerOpen Journal ORIGINAL RESEARCH Open Access An international evaluation of ultrasound vs. computed tomography in the diagnosis of appendicitis Betzalel Reich1 4 Todd Zalut2 and Scott G Weiner3 Abstract Background Abdominal computed tomography scan CT is the preferred radiographic study for the diagnosis of appendicitis in the United States while radiologist-operated ultrasound US is often used in Israel. This comparative international study evaluates the performance of CT vs. US in the evaluation of acute appendicitis. Methods A retrospective chart analysis was conducted at two tertiary care teaching hospitals one in each country. Adult patients age 18-99 with an Emergency Department ED working diagnosis of appendicitis between 1 January 2005 and 31 December 2006 were reviewed. Included patients had at least one imaging study went to the OR and had documented surgical pathology results. Results Of 136 patients in the United States with the ED diagnosis of appendicitis 79 met inclusion criteria for the CT cohort. Based on pathology CT had a sensitivity of 100 95 CI 95.4-100 . The negative appendectomy rate in patients with positive CT was 0 . Total median ED length of stay was 533 min IQR 450-632 and median time from CT order to completion was 184 min IQR 147-228 . Of 520 patients in Israel 197 were included in the US cohort. Based on final pathology US had a sensitivity of 68.4 95 CI 61.2-74.8 . The negative appendectomy rate in patients with positive US was 5.5 . The median ED length of stay for these patients was 387 min IQR 259571.5 . Of the patients 23.4 had subsequent CT scans. Median time from US order to completion was 20 min IQR 7-49 . Both time values were p 0.001 when compared with CT. We furthermore calculate that a first pass approach of using US first and then performing a confirmatory CT scan in .
