Suspected acute appendicitis: nonenhanced helical CT in 300 consecutive patients.

Abstract:

PURPOSE:To determine the accuracy of helical computed tomography (CT) without the oral, intravenous, or rectal administration of contrast material in confirming suspected acute appendicitis. MATERIALS AND METHODS:Three hundred consecutive patients referred from the departments of surgery and emergency medicine were examined for suspected acute appendicitis by using thin-section nonenhanced helical CT. All transverse CT scans were obtained in a single breath hold from the upper abdomen (T12 vertebra) to the pubic symphysis with 5-mm collimation and a pitch of 1.6. All scans were obtained without oral, intravenous, or rectal contrast material. Criteria for diagnosis of acute appendicitis included an enlarged appendix (> 6 mm) and periappendiceal inflammation. CT diagnoses were recorded prospectively. Final diagnoses were established with the results of surgical or clinical follow-up or both. RESULTS:There were 110 true-positive diagnoses, 181 true-negative diagnoses (63 of which were an alternative diagnosis correctly established prospectively), five false-negative diagnoses, and four false-positive diagnoses, which yielded a sensitivity of 96%, a specificity of 99%, and an accuracy of 97%. CONCLUSION:Nonenhanced helical CT is a highly accurate technique for diagnosing or excluding acute appendicitis. Developing experience with the technique and understanding the subtleties of interpretation can further improve diagnostic accuracy.

journal_name

Radiology

journal_title

Radiology

authors

Lane MJ,Liu DM,Huynh MD,Jeffrey RB Jr,Mindelzun RE,Katz DS

doi

10.1148/radiology.213.2.r99nv44341

subject

Has Abstract

pub_date

1999-11-01 00:00:00

pages

341-6

issue

2

eissn

0033-8419

issn

1527-1315

journal_volume

213

pub_type

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