Added Value of Coronal Reformations for Duty Radiologists and for Referring Physicians or Surgeons in the CT Diagnosis of Acute Appendicitis.
- Author:
Kyoung Ho LEE
1
;
Young Hoon KIM
;
Seokyung HAHN
;
Kyung Won LEE
;
Hak Jong LEE
;
Tae Jung KIM
;
Sung Bum KANG
;
Joong Ho SHIN
;
Byung Joo PARK
Author Information
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords: Appendicitis; Computed tomography (CT), image display and recording; Computed tomography (CT), image processing; Computed tomography (CT), three-dimensional; Computed tomography (CT), comparative studies
- MeSH: *Tomography, X-Ray Computed; Sensitivity and Specificity; Retrospective Studies; Referral and Consultation; Radiographic Image Enhancement; ROC Curve; Middle Aged; Male; Humans; Female; Appendicitis/*radiography/surgery; Aged, 80 and over; Adult; Adolescent; Acute Disease
- From:Korean Journal of Radiology 2006;7(2):87-96
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: To assess the added value of coronal reformation for radiologists and for referring physicians or surgeons in the CT diagnosis of acute appendicitis. MATERIALS AND METHODS: Contrast-enhanced CT was performed using 16-detector-row scanners in 110 patients, 46 of whom had appendicitis. Transverse (5-mm thickness, 4-mm increment), coronal (5-mm thickness, 4-mm increment), and combined transverse and coronal sections were interpreted by four radiologists, two surgeons and two emergency physicians. The area under the receiver operating characteristic curve (Az value), sensitivity, specificity (McNemar test), diagnostic confidence and appendiceal visualization (Wilcoxon signed rank test) were compared. RESULTS: For radiologists, the additional coronal sections tended to increase the Az value (0.972 vs. 0.986, p = 0.076) and pooled sensitivity (92% [95% CI: 88, 96] vs. 96% [93, 99]), and enhanced appendiceal visualization in true-positive cases (p = 0.031). For non-radiologists, no such enhancement was observed, and the confidence for excluding acute appendicitis declined (p = 0.013). Coronal sections alone were inferior to transverse sections for diagnostic confidence as well as appendiceal visualization for each reader group studied (p < 0.05). CONCLUSION: The added value of coronal reformation is more apparent for radiologists compared to referring physicians or surgeons in the CT diagnosis of acute appendicitis.
