Comparison of US and Unenhanced Multi–Detector Row CT in Patients Suspected of having Acute Appendicitis

Keyzer, Caroline; Zalcman, Marc; Maertelaer, Viviane De; Coppens, Emmanuel; Bali, Monia; Gevenois, Pierre Alain; Gansbeke, Daniel Van

doi:10.1148/radiol.2362040984

Cited by 88 publications

(32 citation statements)

References 26 publications

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“…Although a 7.5 MHz probe with an annular array transducer was generally used, a 5 MHz convex probe was also employed depending on the patient's physique and the depth of the appendix. On the basis of ultrasonograph findings, appendicitis was classified as follows: catarrhal (appendix was tubular with a clear layer structure of the appendiceal wall, slight mucosal oedema, and a maximum transverse diameter of 10 mm); phlegmonous (ill-defined layer structure of the appendix wall, moderate enlargement of the appendix, and a maximum transverse diameter of 10 mm); gangrenous (illdefined or unidentifiable layer structure of the appendiceal wall and severe enlargement of the appendix to form a mass) [13].…”

Section: Data Collectionmentioning

confidence: 99%

Sensitivity and specificity of ultrasound in the diagnosis of acute appendicitis

Alajerami

2012

East Mediterr Health J

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The aim of this study was to evaluate the sensitivity and specificity of ultrasound in the diagnosis of acute appendicitis at Al-Shefa hospital, Gaza Strip, Palestine. Patients who had appendicitis diagnosed by ultrasound over the study period (n = 180) underwent surgical excision of the appendix. The negative appendectomy rate was low, with only 4.4% (8/180) false positives. A significantly higher false diagnosis rate (false negatives + false positives) was obtained in female patients than in males: 38.5% versus 6.2%. A high proportion of falsely diagnosed cases had abnormal weight (overweight or obese) (82.1%). The overall sensitivity and specificity of ultrasound, using surgical outcome as the gold standard, were 84.8% and 83.3% respectively, and the positive and negative predictive values were 93.3% and 66.7% respectively. Sensitivity and specificity were higher in males (95.7% and 88.2% respectively) than females (84.6% and 71.4% respectively). ‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫عرش‬ ‫الثامن‬ ‫املجلد‬ ‫األول‬ ‫العدد‬ 67

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Section: Data Collectionmentioning

confidence: 99%

Sensitivity and specificity of ultrasound in the diagnosis of acute appendicitis

Alajerami

2012

East Mediterr Health J

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“…contrast enhanced CT in this setting, but limited in its sensitivity [6,10,12,15,17]. Others reported that ultrasound achieves similar results to unenhanced CT, but is mainly restricted by a large number of indeterminate cases [18].…”

Section: Introductionmentioning

confidence: 99%

Acute appendicitis: prospective evaluation of a diagnostic algorithm integrating ultrasound and low-dose CT to reduce the need of standard CT

et al. 2011

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Objectives To evaluate an algorithm integrating ultrasound and low-dose unenhanced CT with oral contrast medium (LDCT) in the assessment of acute appendicitis, to reduce the need of conventional CT. Methods Ultrasound was performed upon admission in 183 consecutive adult patients (111 women, 72 men, mean age 32) with suspicion of acute appendicitis and a BMI between 18.5 and 30 (step 1). No further examination was recommended when ultrasound was positive for appendicitis, negative with low clinical suspicion, or demonstrated an alternative diagnosis. All other patients underwent LDCT (30 mAs) (step 2). Standard intravenously enhanced CT (180 mAs) was performed after indeterminate LDCT (step 3). Results No further imaging was recommended after ultrasound in 84 (46%) patients; LDCT was obtained in 99 (54%). LDCT was positive or negative for appendicitis in 81 (82%) of these 99 patients, indeterminate in 18 (18%) who underwent standard CT. Eighty-six (47%) of the 183 patients had a surgically proven appendicitis. The sensitivity and specificity of the algorithm were 98.8% and 96.9%. Conclusions The proposed algorithm achieved high sensitivity and specificity for detection of acute appendicitis, while reducing the need for standard CT and thus limiting exposition to radiation and to intravenous contrast media.

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“…Because acute appendicitis is a common abdominal emergency affecting young adults, the high amount of radiation dose delivered by abdominal CT raises a major concern with regard to its systematic use as the first-line examination tool in this population [10,11]. To reduce the radiation dose, some authors suggest that sonography should be the initial screening of patients with suspicion of appendicitis [12][13][14][15]. However, in spite of the fact that, in skilled hands, sonography has been reported to be highly specific in the depiction of appendicitis, it is limited by a high rate of false negative or indeterminate results [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a low-dose CT protocol with oral contrast for assessment of acute appendicitis

et al. 2008

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The aim of this study was to evaluate a low-dose CT with oral contrast medium (LDCT) for the diagnosis of acute appendicitis and compare its performance with standard-dose i.v. contrast-enhanced CT (standard CT) according to patients' BMIs. Eighty-six consecutive patients admitted with suspicion of acute appendicitis underwent LDCT (30 mAs), followed by standard CT (180 mAs). Both examinations were reviewed by two experienced radiologists for direct and indirect signs of appendicitis. Clinical and surgical follow-up was considered as the reference standard. Appendicitis was confirmed by surgery in 37 (43%) of the 86 patients. Twenty-nine (34%) patients eventually had an alternative discharge diagnosis to explain their abdominal pain. Clinical and biological follow-up was uneventful in 20 (23%) patients. LDCT and standard CT had the same sensitivity (100%, 33/33) and specificity (98%, 45/46) to diagnose appendicitis in patients with a body mass index (BMI) ≥ 18.5. In slim patients (BMI < 18.5), sensitivity to diagnose appendicitis was 50% (2/4) for LDCT and 100% (4/4) for standard CT, while specificity was identical for both techniques (67%, 2/3). LDCT may play a role in the diagnostic workup of patients with a BMI ≥ 18.5.

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Comparison of US and Unenhanced Multi–Detector Row CT in Patients Suspected of having Acute Appendicitis

Abstract: Although the diagnostic performances of US and multi-detector row CT are comparable, more inconclusive images were obtained with US.

Cited by 88 publications

References 26 publications

Sensitivity and specificity of ultrasound in the diagnosis of acute appendicitis

Sensitivity and specificity of ultrasound in the diagnosis of acute appendicitis

Acute appendicitis: prospective evaluation of a diagnostic algorithm integrating ultrasound and low-dose CT to reduce the need of standard CT

Evaluation of a low-dose CT protocol with oral contrast for assessment of acute appendicitis

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