Application value of abdominal ultrasonography in the diagnosis of pediatric patients aged 3-12 years with acute appendicitis.

Background: Early detection of acute appendicitis (AA) in pediatric cases, critical to avoiding life-threatening complications such as perforation or abscess, remains challenging.

Aim: To evaluate the utility of abdominal ultrasonography (AUS) in diagnosing pediatric AA.

Methods: Overall, 102 pediatric patients (aged 3-12 years) suspected of having AA were enrolled and divided into the AA (n = 78) and non-AA (n = 24) groups. All children underwent AUS and computed tomography (CT). Comparative analyses regarding general patient characteristics and appendix-specific parameters were conducted. The diagnostic performance of AUS and CT in pediatric AA was evaluated.

Results: All appendix-related parameters were greater in the AA group than in the non-AA group. The areas under the receiver-operating characteristic curves for pediatric AA diagnosis using AUS, CT, and AUS + CT were 0.870, 0.824, and 0.931 (all P < 0.001), respectively (AUS: 94.87% sensitivity, 79.17% specificity; CT: 89.74% sensitivity, 75.00% specificity; combined: 98.72% sensitivity, 87.50% specificity). The positive predictive value (PPV), negative predictive value (NPV), accuracy rate, positive detection rate, and misdiagnosis rate of AUS were 93.67%, 82.61%, 91.18%, 72.55%, and 20.83%, respectively. CT had a slightly lower PPV (92.11%) and NPV (69.23%), along with accuracy, positive detection, and misdiagnosis rates of 86.27%, 68.63%, and 25%, respectively. Their combination improved performance, yielding 96.25% PPV, 95.45% NPV, 96.08% accuracy, 75.49% positive detection rate, and 12.50% misdiagnosis rate.

Conclusion: AUS demonstrates certain diagnostic potential in AA diagnosis in pediatric patients, and its combination with CT further improves diagnostic efficacy.