The value of unenhanced CT in the diagnosis of acute appendicitis

D'Ippólito, Giuseppe; Mello, Giselle Guedes Netto de; Szejnfeld, Jacob

doi:10.1590/s1516-31801998000600003

Cited by 13 publications

(5 citation statements)

References 31 publications

(63 reference statements)

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“…9 In our study, the PPV of FACT was 98.9% and NPV was 92.6 %. These results are also supported by other studies which proved positive predictive values of FACT ranging from of 92%-98%, and negative predictive values of 83%-100% 23,24,25 . We found that FACT established an alternative diagnosis in 40 out of total 335 patients (11.9%) with no signs of acute appendicitis on CT. During surgery, no new pathological abnormality was found, and all of the alternative diagnoses were shown to be correct.…”

Section: Discussionsupporting

confidence: 87%

Diagnostic Accuracy of Fact in Clinically Suspected Cases of Acute Appendicitis in Adolescents and Adults, Taking Surgical Findings as Gold Standard

Butt¹,

Nasim²,

Javed³

et al. 2022

PJMHS

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Objective: to evaluate the diagnostic accuracy of FACT in clinically suspected cases of Acute Appendicitis in adolescents and adults, taking surgical findings as gold standard. Methods: A total of 335 patients referred from emergency department with clinical suspicion of acute appendicitis were enrolled at Radiology Department, Services Hospital Lahore, from April, 2016 to October, 2016. FACT was performed using multi-slice CT. The cases underwent surgery and the results were recorded. The results of Focused Abdominal Computed Tomography and surgery were compared taking surgical findings as gold standard. Results: The mean age of patients in our study was 23.01 ± 5.479. We found 278 true-positives, 50 true-negatives, 04 false-negatives results, with sensitivity of 98.6%, a specificity of 94.3%, a PPV of 98.9%, a NPV of 92.6%, and an accuracy of 98%. An alternate diagnosis was made by FACT in 40 patients (11.9%). Conclusion: FACT (focused non-enhanced abdominal computed tomography) is a highly accurate imaging modality for diagnosis of acute appendicitis in adolescents and adults. Keywords: Focused Abdominal CT, Acute Appendicitis, FACT, Diagnostic Acuuracy

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Section: Discussionsupporting

confidence: 87%

Diagnostic Accuracy of Fact in Clinically Suspected Cases of Acute Appendicitis in Adolescents and Adults, Taking Surgical Findings as Gold Standard

Butt¹,

Nasim²,

Javed³

et al. 2022

PJMHS

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“…Additionally, unenhanced CT of the abdomen and pelvis protocol was also used as it can avoid the side effects induced by the contrast medium. Although the unenhanced method can provide the desired accuracy as well, the overall usefulness is still questionable, especially in the cases of children and women [ 145 , 146 , 147 , 148 ]. Interestingly, LDCT has been shown to be comparable to conventional dose CT in terms of clinical outcomes and diagnostic performance [ 149 , 150 ].…”

Section: Imaging Of Gastrointestinal Diseasesmentioning

confidence: 99%

Imaging of Gastrointestinal Tract Ailments

Sun

Liu

et al. 2023

J. Imaging

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Gastrointestinal (GI) disorders comprise a diverse range of conditions that can significantly reduce the quality of life and can even be life-threatening in serious cases. The development of accurate and rapid detection approaches is of essential importance for early diagnosis and timely management of GI diseases. This review mainly focuses on the imaging of several representative gastrointestinal ailments, such as inflammatory bowel disease, tumors, appendicitis, Meckel’s diverticulum, and others. Various imaging modalities commonly used for the gastrointestinal tract, including magnetic resonance imaging (MRI), positron emission tomography (PET) and single photon emission computed tomography (SPECT), and photoacoustic tomography (PAT) and multimodal imaging with mode overlap are summarized. These achievements in single and multimodal imaging provide useful guidance for improved diagnosis, staging, and treatment of the corresponding gastrointestinal diseases. The review evaluates the strengths and weaknesses of different imaging techniques and summarizes the development of imaging techniques used for diagnosing gastrointestinal ailments.

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“…Variações nos protocolos foram observadas no estudo de Smith et al (18) , que utilizou técnica convencional em parte dos pacientes e realizou reconstruções com 2 mm de incremento nos exames com técni-ca espiral; no estudo de D'Ippolito et al (3) , cujos exames foram realizados com técnica convencional com cortes contíguos de 8 a 10 mm de espessura; no trabalho de Rao et al (7) , que administrou contraste por via retal (VR) para avaliação de pacientes com suspeita de apendicite aguda; e no trabalho de Sommer et al (19) , que avaliou a utilidade de reconstruções coronais oblíquas e de reformatações multiplanares dos ureteres para avaliar a presença de cálculos.…”

Section: Técnicaunclassified

“…O exame ultra-sonográfico tem sido amplamente utilizado no diagnóstico de apendicite aguda, em virtude do seu baixo custo, da sua grande disponibilidade e por ser inócuo, apresentando sensibilidade e especificidade que variam de 75% a 93% e de 91% a 100%, respectivamente (3,54) . Todavia, trata-se de um método operadordependente, que requer alta capacitação e experiência do examinador, devendo-se salientar ainda a dificuldade do exame em Figura 2.…”

Section: Apendicite Agudaunclassified

Tomografia computadorizada sem contraste intravenoso no abdome agudo: quando e por que usar

Filho

Jesus²,

D'Ippólito

et al. 2006

Radiol Bras

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A tomografia computadorizada sem contraste intravenoso tem sido freqüentemente proposta na avaliação inicial de pacientes com suspeita de abdome agudo, ocupando o espaço de outros métodos diagnósticos. Os autores apresentam uma revisão bibliográfica dos principais aspectos e eficácia da tomografia computadorizada sem contraste intravenoso no diagnóstico de apendicite aguda, cólica nefrética, diverticulite, pancreatite aguda, apendicite epiplóica, pneumoperitônio e obstrução intestinal. Discutem quais as vantagens e limitações desta técnica de exame, bem como seus aspectos práticos. Unitermos: Apendicite; Diverticulite; Abdome agudo; Tomografia computadorizada; Contraste.When and why use unenhanced computed tomography in patients with acute abdomen. The use of unenhanced computed tomography has been frequently recommended for the initial assessment of patients with clinical suspicion of acute abdomen instead of other diagnostic methods. The authors present a review of the literature on the main aspects, advantages, limitations and efficacy of unenhanced computed tomography for the diagnosis of acute appendicitis, renal colic, diverticulitis, acute pancreatitis, primary epiploic appendicitis, pneumoperitoneum and small bowel obstruction. ciente com abdome agudo têm permitido difundir o seu uso, apesar do custo elevado e certa morbidade, quando comparado a outros métodos de imagem como a radiografia simples do abdome e a ultra-sonografia (US). A utilização seletiva de contraste intravenoso (IV) em exames de TC do abdome permite reduzir significativamente estes limites do método e aumentar a sua disseminação e a sua utilidade.Inúmeros relatos têm demonstrado a grande utilidade da TC abdominal sem injeção intravenosa de meio de contraste no diagnóstico de diferentes condições abdominais agudas, principalmente na identificação de apendicite aguda, diverticulite e de cálculos ureterais . É importante observar que apesar de certa controvérsia, o uso da TC de abdome sem contraste IV não exclui a possibilidade da implementação posterior da fase contrastada, sempre que considerada pertinente, garantindo-se assim a plena potencialidade do método.Mais recentemente, o uso da TC sem contraste tem sido proposto como método alternativo à radiografia simples para a avaliação inicial de pacientes com suspeita de abdome agudo, principalmente por sua elevada sensibilidade e especificidade, INTRODUÇÃOO uso da tomografia computadorizada (TC) como método de investigação do abdome representa um aprimoramento significativo no diagnóstico de diversas doenças, com conseqüente impacto nas decisões terapêuticas. Isto tem sido particularmente útil na avaliação do abdome agudo, situação na qual, para o tratamento adequado, são fundamentais a precisão e rapidez diagnósticas, fatores estes potencializados pela introdução das técnicas espiral e com multidetectores e pelo conhecimento acumulado na utilização desta ferramenta diagnóstica.Os bons resultados obtidos com a utilização da TC helicoidal no estudo do paaliada à sua rapidez e crescente dis...

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The value of unenhanced CT in the diagnosis of acute appendicitis

Abstract: Unenhanced CT presents a similar overall accuracy to that reported by other authors who studied enhanced CT diagnosis of acute appendicitis.

Cited by 13 publications

References 31 publications

Diagnostic Accuracy of Fact in Clinically Suspected Cases of Acute Appendicitis in Adolescents and Adults, Taking Surgical Findings as Gold Standard

Diagnostic Accuracy of Fact in Clinically Suspected Cases of Acute Appendicitis in Adolescents and Adults, Taking Surgical Findings as Gold Standard

Imaging of Gastrointestinal Tract Ailments

Tomografia computadorizada sem contraste intravenoso no abdome agudo: quando e por que usar

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