| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
1 Department of Radiology, UCLA Center for the Health Sciences, 10833 Le Conte
Ave., Los Angeles, CA 90095-1721.
2 Department of Surgery, UCLA Center for the Health Sciences, Los Angeles, CA
90095-1721.
OBJECTIVE. The clinical usefulness of routine, nonfocused helical CT was evaluated in diagnosing acute appendicitis or providing an alternative diagnosis in patients presenting to the emergency department with acute lower abdominal pain.
MATERIALS AND METHODS. We reviewed CT reports and clinical records of 650 consecutive adult patients who presented between January 1996 and December 2000 with right lower quadrant pain or lower abdominal pain and clinical findings suggestive of appendicitis. Helical CT was performed with oral contrast material in 610 cases (93.8%) and IV contrast in 572 cases (88.0%). Both vascular and enteric contrast media were administered in 544 cases (83.7%). Rectal contrast material was administered in 52 cases (8.0%). The abdomen was helically scanned from the dome of the diaphragm to the iliac crests with a collimation of 7 mm, from the iliac crests to the acetabular roof at a 5-mm collimation, from the acetabular roof to the symphysis pubis with a collimation of 5-10 mm. The surgical or clinical record was used for follow-up.
RESULTS. Of the 650 patients, 552 (84.9%) had adequate clinical follow-up. There were 137 true-positive, eight false-positive, five false-negative, and 402 true-negative cases. The sensitivity, specificity, and accuracy of nonfocused helical CT were 96.5%, 98.0%, 97.6%, respectively. The positive and negative predictive values were 94.5% and 98.8%, respectively. In patients without acute appendicitis, CT suggested an alternative diagnosis, which clinically explained the patient's acute abdominal pain in 266 patients (66.2%).
CONCLUSION. Nonfocused helical CT was highly accurate in diagnosing acute appendicitis or suggesting an alternative diagnosis in patients with acute lower abdominal pain or right lower quadrant pain.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
|
|
 |
|
  R. O. Nathan, C. C. Blackmore, and J. G. Jarvik Therapeutic Impact of CT of the Appendix in a Community Hospital Emergency Department Am. J. Roentgenol., October 1, 2008; 191(4): 1102 - 1106. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K-H Lin, W-S Leung, C-P Wang, and W-K Chen Cost analysis of management in acute appendicitis with CT scanning under a hospital global budgeting scheme Emerg. Med. J., March 1, 2008; 25(3): 149 - 152. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. S. Raman, F. C. Osuagwu, B. Kadell, H. Cryer, J. Sayre, and D. S.K. Lu Effect of CT on False Positive Diagnosis of Appendicitis and Perforation N. Engl. J. Med., February 28, 2008; 358(9): 972 - 973. [Full Text] [PDF]
|
|
|
|
 |
|
 E M Anderson and H K Bungay Imaging investigation of acute right iliac fossa pain Imaging, December 1, 2006; 18(4): 257 - 267. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. J. Hebert, A. J. Taylor, and T. C. Winter Comparison of colonic transit between polyethylene glycol and water as oral contrast vehicles in the CT evaluation of acute appendicitis. Am. J. Roentgenol., November 1, 2006; 187(5): 1188 - 1191. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. Doria, R. Moineddin, C. J. Kellenberger, M. Epelman, J. Beyene, S. Schuh, P. S. Babyn, and P. T. Dick US or CT for Diagnosis of Appendicitis in Children and Adults? A Meta-Analysis Radiology, October 1, 2006; 241(1): 83 - 94. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Ganguli, V. Raptopoulos, F. Komlos, B. Siewert, and J. B. Kruskal Right Lower Quadrant Pain: Value of the Nonvisualized Appendix in Patients at Multidetector CT Radiology, October 1, 2006; 241(1): 175 - 180. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. F. Thoeni and J. P. Cello CT Imaging of Colitis Radiology, September 1, 2006; 240(3): 623 - 638. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. K. Iglehart The new era of medical imaging--progress and pitfalls. N. Engl. J. Med., June 29, 2006; 354(26): 2822 - 2828. [Full Text] [PDF]
|
|
|
|
|
|
C. Keyzer, M. Zalcman, V. De Maertelaer, E. Coppens, M.-A. Bali, P. A. Gevenois, and D. Van Gansbeke Comparison of US and Unenhanced Multi-Detector Row CT in Patients Suspected of having Acute Appendicitis Radiology, August 1, 2005; 236(2): 527 - 534. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. P. Daly, R. H. Cohan, I. R. Francis, E. M. Caoili, J. H. Ellis, and B. Nan Incidence of Acute Appendicitis in Patients with Equivocal CT Findings Am. J. Roentgenol., June 1, 2005; 184(6): 1813 - 1820. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Yu, A. S. Fulcher, M. A. Turner, and R. A. Halvorsen Helical CT Evaluation of Acute Right Lower Quadrant Pain: Part I, Common Mimics of Appendicitis Am. J. Roentgenol., April 1, 2005; 184(4): 1136 - 1142. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Foley, F. Earnest IV, M. A. Nathan, D. M. Hough, H. J. Schiller, and T. L. Hoskin Differentiation of Nonperforated from Perforated Appendicitis: Accuracy of CT Diagnosis and Relationship of CT Findings to Length of Hospital Stay Radiology, April 1, 2005; 235(1): 89 - 96. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. J. Hansen, S. W. Young, G. De Petris, D. J. Tessier, J. L. Hernandez, and D. J. Johnson Histologic Severity of Appendicitis Can Be Predicted by Computed Tomography Arch Surg, December 1, 2004; 139(12): 1304 - 1308. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Poortman, P. N. M. Lohle, C. M. C. Schoemaker, H. J. M. Oostvogel, H. J. L. J. M. Teepen, K. A. H. Zwinderman, and J. F. Hamming Comparison of CT and Sonography in the Diagnosis of Acute Appendicitis: A Blinded Prospective Study Am. J. Roentgenol., November 1, 2003; 181(5): 1355 - 1359. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Tarantino, A. Giorgio, G. de Stefano, V. Scala, F. Esposito, G. Liorre, N. Farella, and G. Ferraioli Acute Appendicitis Mimicking Infectious Enteritis: Diagnostic Value of Sonography J. Ultrasound Med., September 1, 2003; 22(9): 945 - 950. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. K. Paulson, M. F. Kalady, and T. N. Pappas Suspected Appendicitis N. Engl. J. Med., January 16, 2003; 348(3): 236 - 242. [Full Text] [PDF]
|
|
|
|
 |
|
 I. S Benjamin and A G Patel Managing acute appendicitis BMJ, September 7, 2002; 325(7363): 505 - 506. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
