Acute Appendicitis: Sensitivity, Specificity and Diagnostic Accuracy of Thin-Section Contrast-Enhanced CT Findings.
10.3348/jkrs.2002.47.4.379
- Author:
Ji Yon LEE
1
;
Dongil CHOI
;
Haewon PARK
;
Young Rae LEE
;
Shin Ho KOOK
;
Hyon Joo KWAG
;
Seung Kwon KIM
;
Eun Chul CHUNG
Author Information
1. Department of Radiology, Kangbuk Samsung Hospital, Samsung Medical Center. acromion@unitel.co.kr
- Publication Type:Original Article
- Keywords:
Appendicitis;
Appendix, CT;
Computed tomography (CT), helical technology
- MeSH:
Abscess;
Appendicitis*;
Appendix;
Cellulitis;
Colon;
Diagnosis;
Humans;
Lymphatic Diseases;
Retrospective Studies;
Sensitivity and Specificity*;
Tomography, Spiral Computed;
Tomography, X-Ray Computed*
- From:Journal of the Korean Radiological Society
2002;47(4):379-387
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To assess the sensitivity, specificity, and diagnostic accuracy of individual contrast-enhanced helical CT findings of acute appendicitis. MATERIALS AND METHODS: We retrospectively reviewed the appendiceal helical CT scans, obtained after intravenous contrast administration (abdomen; 7-mm collimation, abdominopelvic junction; 5-mm collimation), of 50 patients with surgically proven acute appendicitis and 112 with alternative diagnoses. The following parameters were analysed by three radiologists: enlarged appendix (> 6 mm in diameter), appendiceal wall thickening, appendiceal wall enhancement, no identification of the appendix, appendicolith(s), (appendiceal) intraluminal air, (appendiceal) intraluminal air extraluminal air, periappendiceal fat stranding, extraluminal fluid, phlegmon, abscess, lymphadenopathy, terminal ileal wall thickening, focal cecal apical thickening, focal colonic wall thickening, and segmental colonic wall thickening. RESULTS: The CT findings of acute appendicitis that statistically distinguished it from alternative diagnoses were an enlarged appendix (sensitivity; 92%, specificity; 93%, diagnostic accuracy; 93%), appendiceal wall thickening (for these three parameters: 68%, 96% and 88%, respectively), periappendiceal fat stranding (90%, 79%, 82%), appendiceal wall enhancement (72%, 86%, 82%), appendicolith (16%, 100%, 74%), and focal cecal apical thickening (14%, 100%, 74%) (for each, p < 0.05). CONCLUSION: On thin-section contrast-enhanced helical CT, an enlarged appendix and periappendiceal fat stranding were found in 90% or more patients with acute appendicitis. Appendiceal wall thickening and enhancement were clearly demonstrated and significant findings for diagnosis. Less common but specific findings include appendicolith, focal cecal apical thickening and intramural air, can also help us establish a diagnosis of acute appendicitis.
