Accuracy of point-of-care ultrasound and radiology-performed ultrasound for intussusception: A systematic review and meta-analysis

Am J Emerg Med. 2019 Sep;37(9):1760-1769. doi: 10.1016/j.ajem.2019.06.006. Epub 2019 Jun 4.


Objective: It is unclear whether point-of-care ultrasound (POCUS) by emergency medicine physicians is as accurate as radiology-performed ultrasound (RADUS). We aim to summarize the diagnostic accuracy of ultrasonography for intussusception and to compare the performance between POCUS and RADUS.

Methods: Databases were searched from inception through February 2018 using pre-defined index terms. Peer-reviewed primary studies that investigated the diagnostic accuracy of ultrasound for intussusception in children were included. The study is reported using Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA). Meta-analysis of the diagnostic accuracy of ultrasound for intussusception was conducted using the random-effects bivariate model. Subgroup analysis (POCUS vs RADUS) was also performed. Meta-regression was utilized to determine if the diagnostic accuracy between POCUS and RADUS was significantly different.

Results: Thirty studies (n = 5249) were included in the meta-analysis. Ultrasonography for intussusception has a sensitivity: 0.98 (95% CI: 0.96-0.98), specificity: 0.98 (95% CI: 0.95-0.99), positive likelihood ratio: 43.8 (95% CI: 18.0-106.7) and negative likelihood ratio: 0.03 (95% CI: 0.02-0.04), with an area under ROC (AUROC) curve of 0.99 (95% CI: 0.98-1.00). Meta-regression suggested no significant difference in the diagnostic accuracy for intussusception between POCUS and RADUS (AUROC: 0.95 vs 1.00, p = 0.128).

Conclusions: Current evidence suggested POCUS has a high diagnostic accuracy for intussusception not significantly different from that of RADUS.

Keywords: Diagnostic accuracy; Intussusception; Meta-analysis; Point-of-care ultrasound.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adolescent
  • Area Under Curve
  • Child
  • Child, Preschool
  • Emergency Service, Hospital / standards
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Intussusception / diagnosis*
  • Male
  • Point-of-Care Systems / standards*
  • Predictive Value of Tests
  • Prospective Studies
  • Retrospective Studies
  • Ultrasonography / standards*