CT demonstration of the appendix in asymptomatic adults

Scatarige, John C.; DiSantis, David J.; Allen, H A; Miller, M Todd

doi:10.1007/bf01889214

Cited by 24 publications

(13 citation statements)

References 13 publications

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“…Others have demonstrated that visualization of the appendix is related to intravenous or oral contrast material administration [12], although the use of rectal contrast material may be helpful [22,23]. Decreasing the CT slice thickness and the experience of the radiologist are also beneficial in identifying the appendix [13,24]. In complicated cases, confirmation of the vermiform appendix is usually not possible on a single slice and requires inspection of sequential images through the area of the cecal tip [15,23].…”

Section: Discussionmentioning

confidence: 97%

“…Positive identification of the appendix required demonstration of a tubular, linear, or curved structure, with or without a lumen, which arises from the cecal caput. It had to be unequivocally separable from the cecum and adjacent to the small bowel and had to be conform to the expected location of the appendix [4,13].…”

Section: Ct Techniquementioning

confidence: 99%

“…Dixon and Goldstone reported in 2002 [10], about the Euratom Directive, that the use of CT for suspected acute appendicitis can avoid inappropriate surgery or delayed diagnosis, so the risks of radiation exposure more than outweigh the possible benefits. Although several CT signs of appendicitis are well described in the radiological literature [11], few studies have evaluated the normal appendix on CT [12][13][14][15]; CT criteria for normal size and wall thickness are based on data from the ultrasound literature, and CT criteria for the intraluminal content and location are based in large part on experience with barium studies [16][17][18].…”

Section: Introductionmentioning

confidence: 99%

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CT appearance of the normal appendix in adults

et al. 2005

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The aims of this study were to identify (1) the normal range of the appendix on computed tomography (CT), (2) the correlation of patient age and sex with the visibility and appearance of the appendix on CT, and (3) the normal variations in wall thickness, intraluminal content, and location of the appendix. Three hundred seventy-two outpatients underwent abdominopelvic CT. The scans were reviewed on the picture archiving and communication system and appendiceal outer-to-outer wall diameter, wall thickness, location, content and its correlation with appendix diameter were analyzed. The appendix was visualized in 305/372 patients. Its location relative to the cecum was highly variable. The diameter range was 3-10 mm; in 42% of cases the diameter was greater than 6 mm. When the intraluminal content (185/305) was visualized, the diameter was slightly superior to the mean (p=0.0156). In 329 CT scans in which oral contrast material was given, the appendix was filled by contrast material in 74/329 patients. The appendix wall thickness was measurable in 22/305 patients (average 0.15 cm). There is significant overlap between the normal and abnormal CT appearance of the appendix. Consequently the diagnosis of acute appendicitis should be based not only on the appearance of the appendix but also on the presence of secondary signs.

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Section: Discussionmentioning

confidence: 97%

Section: Ct Techniquementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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CT appearance of the normal appendix in adults

et al. 2005

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“…Despite the widespread use of CT to diagnose appendicitis, few studies exist that have systematically evaluated the normal appendix [4], [31], [32], [33], [34]. CT criteria for normal size and wall thickness were based on data from the ultrasound literature.…”

Section: Introductionmentioning

confidence: 99%

The Normal Appendix on CT: Does Size Matter?

et al. 2014

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Purpose(1) To evaluate the frequency of visualisation and measurements of the normal appendix. (2) To correlate Body Mass Index (BMI) and gender with visualisation of the normal appendix. (3) To correlate age, gender and body length with appendiceal length.Materials and MethodsA retrospective review of 186 patients undergoing abdominal CT without suspicion of acute appendicitis was done. Frequency of visualisation and measurements (including maximal outer diameter, wall thickness, length, content, location of base and tip) of normal appendices were recorded.ResultsPrevalence of appendectomy was 34.4%. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of visualisation of the normal appendix were 76%, 94%, 96%, 67%, and 82% respectively. The mean maximal diameter of the appendix was 8.19 mm±1.6 (SD) (range, 4.2–12.8 mm). The mean length of the appendix was 81.11 mm±28.44 (SD) (range, 7.2–158.8 mm). The mean wall thickness of the appendix was 2.22 mm±0.56 (SD) (range, 1.15–3.85 mm). The most common location of the appendiceal tip was pelvic in 66% appendices. The most common location of the appendiceal base was inferior, medial, and posterior in 37%. The normal appendix contained high-density material in 2.2%. There was a significant correlation between gender and appendiceal length, with men having longer appendices than women.ConclusionMost normal appendices are seen at multislice CT using IV contrast. The maximal outer diameter of the normal appendix overlaps with values currently used to diagnose appendicitis on CT.

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“…13 Sonographic criteria for the diagnosis of acute appendicitis included sonographic localization of the appendix at the point of maximal tenderness, an outer diameter of the appendix of greater than 6 mm, noncompressibility of the appendix, and an echogenic periappendiceal inflammatory fat change. The appendix was evaluated for maximal cross-sectional diameter by measurement of the distance between the outer walls and muscle thickness with electronic calipers.…”

Section: Methodsmentioning

confidence: 99%

Improved Sonographic Visualization of the Appendix With a Saline Enema in Children With Suspected Appendicitis

Han

2002

J of Ultrasound Medicine

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Objective. To determine whether abdominal sonography after a saline enema can identify the appendix that is not visualized at graded compression sonography in children with suspected appendicitis. Methods. High-frequency compression sonography was prospectively performed in 120 consecutive children with suspected appendicitis; the appendix was not identified in 27 of these patients. Among the 27 patients with a nonvisualized appendix, abdominal sonography after a saline enema was performed in 12 to identify the appendix. Results. Abdominal sonography after the saline enema revealed the appendix in all 12 children in whom the appendix was not visualized at graded compression sonography. A normal appendix was found in 11 children, and acute appendicitis confined to the appendiceal tip was found in 1. The appendix was located in the pelvis (n = 5), posterior to the cecum (n = 4), posterior to the ileum (n = 2), and anterior to the ileum (n = 1). The appendix could be identified by using a window of the saline-filled sigmoid colon (n = 5), saline-filled cecum (n = 4), and saline-filled terminal ileum (n = 2). Conclusions. Abdominal sonography after a saline enema is a helpful technique for depiction of the appendix that is not visible at graded compression sonography in children with suspected appendicitis.

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CT demonstration of the appendix in asymptomatic adults

Cited by 24 publications

References 13 publications

CT appearance of the normal appendix in adults

CT appearance of the normal appendix in adults

The Normal Appendix on CT: Does Size Matter?

Improved Sonographic Visualization of the Appendix With a Saline Enema in Children With Suspected Appendicitis

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