Low-Dose Abdominal CT for Evaluating Suspected Appendicitis

Kim, Kyuseok; Kim, Young Hoon; Kim, So Yeon; Kim, Su‐Young; Lee, Yoon Jin; Kim, Kwang Pyo; Lee, Hye Seung; Ahn, Soyeon; Kim, Taeyun; Hwang, Seung Sik; Song, Kyu‐Sang; Kang, Sung Bum; Kim, Duck Woo; Park, Seong Ho; Lee, Kyung Ho

doi:10.1056/nejmoa1110734

Cited by 278 publications

(230 citation statements)

References 38 publications

(29 reference statements)

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“…Many studies have shown the value of CTS in evaluation of acute abdominal pain with sensitivity of 90-100%, specificity of 91-99%, accuracies of 94-98%, PPVs of 92-98%, and NPVs of 95-100% for diagnosing AA. [12][13][14] Our results were similar to those published in literature with an overall diagnostic accuracy of 92.6%. Recent trend toward medical management of early AA will make CTS a mandatory diagnostic test for all patients with clinical suspicion of the diagnosis.…”

supporting

confidence: 89%

The Alvarado score versus computed tomography in the diagnosis of acute appendicitis: A prospective study

Al-Faouri

Ajarma

M.Al-Abbadi

et al. 2016

Medical Journal Armed Forces India

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m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 2 ( 2 0 1 6 ) 3 3 2 -3 3Methods: A total of 320 patients with suspected acute appendicitis were included in this study over a period of 2 years. The Alvarado score was calculated for all of these patients and 112 CT scans were requested selectively by surgeons caring for the patients. The histopathology diagnosis was used as the gold standard against which diagnostic performance of Alvarado score and CT scan were compared.Results: The complete data of 196 males and 124 females were analyzed at the end of the study period. The mean age was 26.1 AE 11.3 years. Appendectomy was performed in 263 patients with a negative appendectomy rate of 14.83% overall (12.28 in males and 19.56 in females). The remaining 57 patients were assumed to have no appendicitis. The diagnostic performance of CT scan was superior to that of Alvarado score with sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of 94.2 versus 85.4%, 90 versus 65%, 9.42 versus 2.44, and 0.065 versus 0.224, respectively ( p-value < 0.05). The overall diagnostic accuracy of CT scan was 92.6% compared to 77.5% for Alvarado score. Conclusion:The Alvarado score was far from good and CT scan is more accurate in diagnosis of acute appendicitis in our patient population. #

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supporting

confidence: 89%

The Alvarado score versus computed tomography in the diagnosis of acute appendicitis: A prospective study

Al-Faouri

Ajarma

M.Al-Abbadi

et al. 2016

Medical Journal Armed Forces India

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“…The authors came to the conclusion that low-dose CT is equally suitable for diagnosing appendicitis. For example, Kim et al determined the rates of unnecessary appendectomies in 890 patients after standarddose CT and low-dose CT in a randomized prospective study and compared the results [21]. The patients were divided into two groups.…”

Section: Resultsmentioning

confidence: 99%

Imaging of Appendicitis in Adults

Karul

Berliner

Keller

et al. 2014

Fortschr Röntgenstr

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Three imaging modalities are available for the diagnosis of acute appendicitis: ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). Transabdominal ultrasound should be the first-line imaging test. Abdominal CT is superior to US and is required immediately in patients with atypical clinical presentation of appendicitis and suspected perforation. However, low-dose unenhanced CT is equal to standard-dose CT with intravenous contrast agents in the detection of five signs of acute appendicitis (thickened appendiceal wall more than 2?mm, cross-sectional diameter greater than 6?mm, periappendicitis, abscess, and appendicolith). MRI is necessary in pregnant women and young adults. This review illustrates the principles of state-of-the-art imaging techniques and their clinical relevance. Key Points: ??US is the basic diagnostic method in case of suspected appendicitis. ??CT is necessary in patients with atypical presentation of appendicitis. ??MRI should be the first-line imaging test in pregnant women. Citation Format: ??Karul M, Berliner C, Keller S et?al. Imaging of Appendicitis in Adults. Fortschr R?ntgenstr 2014; 186: 551???558

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“…A recent report by Kim, et al [21] concluded that low-dose abdominal CT was not inferior to standard-dose CT regarding NAR in young adults, with a lower median radiation dose -length product as compared to standard-dose CT (116 mGy * cm vs. 521 mGy * cm, respectively).…”

Section: Disclosurementioning

confidence: 98%

“…If US is inconclusive, we may consider low-dose CT a possible radiological examination in the diagnosis of acute appendicitis [21,22]. With regard to pediatric patients, US is the first choice imaging technique.…”

Section: Disclosurementioning

confidence: 99%

Untitled

2017

Int J Surg Res Pract

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Low-Dose Abdominal CT for Evaluating Suspected Appendicitis

Abstract: Low-dose CT was noninferior to standard-dose CT with respect to negative appendectomy rates in young adults with suspected appendicitis. (Funded by GE Healthcare Medical Diagnostics and others; ClinicalTrials.gov number, NCT00913380.).

Cited by 278 publications

References 38 publications

The Alvarado score versus computed tomography in the diagnosis of acute appendicitis: A prospective study

The Alvarado score versus computed tomography in the diagnosis of acute appendicitis: A prospective study

Imaging of Appendicitis in Adults

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