Diagnostic Accuracy of Ultrasonography for Detection of Intussusception in Children; a Systematic Review and Meta-Analysis

The diagnosis of intussusception can be challenging in children due to the fact that the findings of clinicalevaluations are nonspecific and most of the patients present with unclear history. Therefore, in this systematic reviewand meta-analysis, we aimed to investigate the diagnostic accuracy of ultrasonography for detection of intussusceptionand also compare the efficacy of point-of-care ultrasound (POCUS) with radiologist-performed ultrasound (RADUS).

Two independent reviewers systematically searched different online electronic databases including MED-LINE, Scopus, Web of Science, Google Scholar, Embase, and Cochrane from inception to December 1, 2022 to identifypublished papers reporting accuracy of ultrasonography for diagnosis of intussusception. The quality assessment ofthe included studies was investigated using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool.

A total of 1446 records were retrieved in the initial search of databases. After screening the titles, a total of344 studies were retrieved for the detailed assessment of full-text. Finally, 37 studies were included in qualitative andquantitative analysis. The pooled sensitivity and specificity of ultrasonography for diagnosis of intussusception were0.96 (95% CI: 0.95-0.97) and 0.97 (95% CI: 0.97-0.98), respectively. The pooled positive likelihood ratio (PLR) and nega-tive likelihood ratio (NLR) were 24.57 (95% CI: 8.26-73.03) and 0.05 (95% CI: 0.04-0.08), respectively. The area under thehierarchical summary receiver operating characteristic (HSROC) curve was 0.989. Mete-regression showed that there isno significant difference between diagnostic performance of POCUS and RADUS (p = 0.06 and rDOR (diagnostic oddsratio) = 4.38 (95% CI: 0.92-20.89)).

This meta-analysis shows that ultrasonography has excellent sensitiv-ity, specificity, and accuracy for diagnosis of intussusception in pediatric patients. Moreover, we found that diagnosticperformance of POCUS is similar to that of RADUS for diagnosis of intussusception.