Alternative Diagnoses to Suspected Appendicitis at CT

Pooler, B. Dustin; Lawrence, Edward M.; Pickhardt, Perry J.

doi:10.1148/radiol.12120614

Cited by 62 publications

(37 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, we showed that the probability of achieving a correct alternative diagnosis is lower when scanning the pelvis only rather than the entire abdomen and pelvis. This confirms the major drawback of focused pelvic acquisition is missing alternative diseases by ignoring the upper abdomen [8,14]. In addition, our study shows that the visualisation of the appendix is less frequent with pelvic focused CT than with other acquisitions.…”

Section: Discussionsupporting

confidence: 83%

“…Dose reduction should, however, be considered in young patients only, and elder patients such as those included in our study sample could need a thorough imaging protocol rather than a radiation saving protocol. Nevertheless, as compared with young adults, patients older than 65 years present more frequently a cause of symptoms other than acute appendicitis and are thus an appropriate model for investigating diseases alternative to acute appendicitis [14].…”

Section: Discussionmentioning

confidence: 99%

“…In this study, the readers classified the anatomic location of CT abnormalities as abdominal (above the iliac crest) or pelvic (below the iliac crest) [8]. Finally, a very recent study by Pooler et al [14] assessed CT in the diagnosis of alternative diseases in 1571 patients suspected of acute appendicitis. The authors advocated that the appendix itself as well as alternative diseases may not be demonstrated by CT acquisition limited to the pelvis.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Optimisedz-axis coverage at multidetector-row CT in adults suspected of acute appendicitis

Brassart

Winant²,

Tack³

et al. 2013

BJR

View full text Add to dashboard Cite

Objective: To compare diagnostic performances of two reduced z-axis coverages to full coverage of the abdomen and pelvis for the diagnosis of acute appendicitis and alternative diseases at unenhanced CT. Methods: This study included 152 adults suspected of appendicitis who were enrolled in two ethical committeeapproved previous prospective trials. Based on scans covering the entire abdomen and pelvis (set L), two additional sets of images were generated, each with reduced z-axis coverages: (1) from the top of the iliac crests to the pubis (set S) and (2) from the diaphragmatic crus to the pubis (set M). Two readers independently coded the visualisation of the appendix, measured its diameter and proposed a diagnosis (appendicitis or alternative). Final diagnosis was based on surgical findings or clinical follow-up. Fisher exact and McNemar tests and logistic regression were used.Results: 46 patients had a definite diagnosis of appendicitis and 53 of alternative diseases. The frequency of appendix visualisation was lower for set S than set L for both readers (89% and 84% vs 95% and 91% by Readers A and B, respectively; p50.021 and 0.022). The probability of giving a correct diagnosis was lower for set S (68%) than set L (78%; odds ratio, 0.611; p50.008) for both readers, without significant difference between sets L and M (77%, p50.771); z-axis coverage being reduced by 25% for set M. Conclusion: Coverage from diaphragmatic crus to pubis, but not focused on pelvis only, can be recommended in adults suspected of appendicitis. Advances in knowledge: In suspected appendicitis, CT-coverage can be reduced from diaphragmatic crus to pubis.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Optimisedz-axis coverage at multidetector-row CT in adults suspected of acute appendicitis

Brassart

Winant²,

Tack³

et al. 2013

BJR

View full text Add to dashboard Cite

show abstract

“…13 CT is the most accurate imaging technique for evaluating suspected acute appendicitis and alternative etiologies of right lower quadrant pain. 14,15 Drawbacks of CT include the use of ionizing radiation and the nephrotoxic potential of intravenous iodinated contrast agents. Ultrasound does not use ionizing radiation but is operator-dependent and has a significantly lower diagnostic accuracy.…”

Section: Mr Imaging Findings With Computed Tomography Correlation Acumentioning

confidence: 99%

MR Evaluation of the Nontraumatic Acute Abdomen with CT Correlation

Bannas¹,

Pickhardt²

2015

Radiologic Clinics of North America

Self Cite

View full text Add to dashboard Cite

“…[4][5][6][7][8] Thus, the correct -and differential -diagnosis of AA is of great importance in informing the choice of clinical treatment.…”

Section: Introductionmentioning

confidence: 99%

Comparison of multislice computed tomography and clinical scores for diagnosing acute appendicitis

2015

View full text Add to dashboard Cite

Objective: To compare Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and Alvarado scores with multislice computed tomography (MSCT) for diagnosing acute appendicitis (AA). Methods: This retrospective study included patients with abdominal pain who had undergone MSCT, and whose medical notes included RIPASA and Alvarado score parameters. MSCT was compared with RIPASA and Alvarado scores for diagnosing AA. Results: Of 297 patients included, sensitivity, specificity and accuracy for diagnosing AA were 95.2%, 73.6% and 87.2% for RIPASA score (cutoff value 7.5) and 63.1%, 80.9% and 69.7% for Alvarado score (cutoff value 7). Sensitivity, specificity and accuracy of MSCT for diagnosing AA were 98.9%, 96.4% and 98.0%, respectively. In terms of accuracy, statistically significant differences were observed between RIPASA and Alvarado scores, and between MSCTand RIPASA scores. The mean RIPASA score was significantly different in the simple AA group (9.7 AE 2.2) compared with other AA groups (10.5 AE 1.7). No statistically significant difference was observed in RIPASA score between nonperforated and perforated AA. MSCT sensitivity, specificity and accuracy for diagnosing simple AA were 94.1%, 96.4% and 95.8%, respectively; for differentiating perforated and nonperforated AA, scores were 90.2%, 95.2% and 94.1%, respectively. Conclusion: MSCT is the optimum diagnostic tool for AA, followed by RIPASA score and Alvarado score, particularly in diagnosing simple and perforated AA.

show abstract

Alternative Diagnoses to Suspected Appendicitis at CT

Abstract: In adult patients clinically suspected of having acute appendicitis, abdominopelvic CT frequently identifies an alternative cause for symptoms, which often requires hospitalization and surgery for treatment.

Cited by 62 publications

References 30 publications

Optimisedz-axis coverage at multidetector-row CT in adults suspected of acute appendicitis

Optimisedz-axis coverage at multidetector-row CT in adults suspected of acute appendicitis

MR Evaluation of the Nontraumatic Acute Abdomen with CT Correlation

Comparison of multislice computed tomography and clinical scores for diagnosing acute appendicitis

Contact Info

Product

Resources

About