Evidence map›Paper›PMID 37486585›Full record

ArticlePediatric surgery international2023

Implementation of ultrasound and fast magnetic resonance imaging pathway reduces computed tomography utilization in children with suspected appendicitis.

Gabrielle Steinl, David Grabski, Mark Fleming, Daniel Levin, Eugene McGahren, William McCullough, Jeffrey Gander

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Article in Pediatric surgery international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Gabrielle SteinlDepartment of Surgery, University of Virginia, Charlottesville, USA.
David GrabskiDepartment of Surgery, University of Virginia, Charlottesville, USA.
Mark FlemingDepartment of Surgery, University of Virginia, Charlottesville, USA.
Daniel LevinDivision of Pediatric Surgery, Department of Surgery, University of Virginia School of Medicine, University of Virginia, 1215 Lee St., Charlottesville, VA, 22904, USA.
Eugene McGahrenDivision of Pediatric Surgery, Department of Surgery, University of Virginia School of Medicine, University of Virginia, 1215 Lee St., Charlottesville, VA, 22904, USA.
William McCulloughDepartment of Radiology, Santa Clara Homestead Medical Center, Santa Clara, CA, USA.
Jeffrey GanderDivision of Pediatric Surgery, Department of Surgery, University of Virginia School of Medicine, University of Virginia, 1215 Lee St., Charlottesville, VA, 22904, USA. jg9br@virginia.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeComputed tomography (CT) is still used in the imaging diagnosis of acute appendicitis in children at many hospitals. We implemented an ultrasound (US) and fast magnetic resonance imaging (MRI) pathway for suspected appendicitis at our institution with the goal of reducing radiation exposure in children.

methodsAll children (< 18 years old) who underwent appendectomy between January 2011 and July 2021 were reviewed. Data were collected on all imaging studies performed. In December 2015, we initiated an imaging pathway for suspected acute appendicitis. US was the initial imaging study, and a rapid protocol MRI was performed if US was equivocal. Those could not tolerate MRI underwent CT. We evaluated the difference in percentage of patients who underwent CT before and after pathway initiation.

results554 patients who underwent appendectomy did not have prior imaging studies on presentation to our hospital and were included in analysis. After initiating the pathway, the use of abdominal US increased from 87% (220 of 254) to 97% (291 of 300, p < 0.0001) and the use of MRI increased by 100% (0 MRIs pre-protocol, 90 of 300 patients post-protocol, p < 0.0001). CT utilization decreased significantly from 32% (82 of 254) to 2% (6 of 300, p < 0.0001).

conclusionEmbracing a new US and rapid MRI pathway to evaluate pediatric patients with suspected acute appendicitis resulted in significant reduction in CT utilization and therefore radiation exposure.

Indexed as

AppendicitisAcute DiseaseAdolescentAppendectomyChildHospitals, PediatricHumansMagnetic Resonance ImagingRetrospective StudiesTomography, X-Ray ComputedUltrasonographyAcute appendicitisCTFast MRIRadiation exposure

Identifiers

PMID37486585

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.