Acute Appendicitis: Sensitivity, Specificity and Diagnostic Accuracy of Thin-Section Contrast-Enhanced CT Findings
Journal of the Korean Radiological Society
;
: 379-387, 2002.
Article
in Korean
| WPRIM
| ID: wpr-166743
ABSTRACT
PURPOSE:
To assess the sensitivity, specificity, and diagnostic accuracy of individual contrast-enhanced helical CT findings of acute appendicitis. MATERIALS ANDMETHODS:
We retrospectively reviewed the appendiceal helical CT scans, obtained after intravenous contrast administration (abdomen; 7-mm collimation, abdominopelvic junction; 5-mm collimation), of 50 patients with surgically proven acute appendicitis and 112 with alternative diagnoses. The following parameters were analysed by three radiologists enlarged appendix (> 6 mm in diameter), appendiceal wall thickening, appendiceal wall enhancement, no identification of the appendix, appendicolith(s), (appendiceal) intraluminal air, (appendiceal) intraluminal air extraluminal air, periappendiceal fat stranding, extraluminal fluid, phlegmon, abscess, lymphadenopathy, terminal ileal wall thickening, focal cecal apical thickening, focal colonic wall thickening, and segmental colonic wall thickening.RESULTS:
The CT findings of acute appendicitis that statistically distinguished it from alternative diagnoses were an enlarged appendix (sensitivity; 92%, specificity; 93%, diagnostic accuracy; 93%), appendiceal wall thickening (for these three parameters 68%, 96% and 88%, respectively), periappendiceal fat stranding (90%, 79%, 82%), appendiceal wall enhancement (72%, 86%, 82%), appendicolith (16%, 100%, 74%), and focal cecal apical thickening (14%, 100%, 74%) (for each, p < 0.05).CONCLUSION:
On thin-section contrast-enhanced helical CT, an enlarged appendix and periappendiceal fat stranding were found in 90% or more patients with acute appendicitis. Appendiceal wall thickening and enhancement were clearly demonstrated and significant findings for diagnosis. Less common but specific findings include appendicolith, focal cecal apical thickening and intramural air, can also help us establish a diagnosis of acute appendicitis.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Appendicitis
/
Appendix
/
Tomography, X-Ray Computed
/
Cellulitis
/
Retrospective Studies
/
Sensitivity and Specificity
/
Colon
/
Tomography, Spiral Computed
/
Diagnosis
/
Abscess
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
Korean
Journal:
Journal of the Korean Radiological Society
Year:
2002
Type:
Article
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