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Normal Appendix in Adults: Reproducibility of Detection with Unenhanced and Contrast-Enhanced MDCT

Caroline Keyzer1, Stanislav Pargov1, Denis Tack2, Viviane Créteur1, Pascale Bohy2, Viviane De Maertelaer3 and Pierre Alain Gevenois2

1 Department of Radiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium.
2 Department of Radiology, Hôpital Erasme, Université libre de Bruxelles, Route de Lennik 808, B-1070 Brussels, Belgium.
3 Service of Biostatistics and Medical Informatics and Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire, Université libre de Bruxelles, Brussels, Belgium.


Figure 1
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  		Fig. 1A —58-year-old woman with normal appendix. Transverse contrast-enhanced CT scans show normal appendix marked on four contiguous images. All readers and experts agreed to same structure as normal appendix.

 

Figure 2
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  		Fig. 1B —58-year-old woman with normal appendix. Transverse contrast-enhanced CT scans show normal appendix marked on four contiguous images. All readers and experts agreed to same structure as normal appendix.

 

Figure 3
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  		Fig. 1C —58-year-old woman with normal appendix. Transverse contrast-enhanced CT scans show normal appendix marked on four contiguous images. All readers and experts agreed to same structure as normal appendix.

 

Figure 4
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  		Fig. 1D —58-year-old woman with normal appendix. Transverse contrast-enhanced CT scans show normal appendix marked on four contiguous images. All readers and experts agreed to same structure as normal appendix.

 

Figure 5
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  		Fig. 2 —Graphs show Cohen's kappa coefficient for assessing agreement in categorizing confidence in identification of normal appendix within readers (A) and between readers (B). Error bars indicate 95% CI. Closed shapes indicate unenhanced CT; open shapes, contrast-enhanced CT.

 

Figure 6
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Figure 7
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  		Fig. 3A —60-year-old man undergoing evaluation for cancer diagnosis. Transverse unenhanced CT scans show organ marked as appendix by reader A at first reading session (A–D) and at second reading session (E–H). Case is example of intrareader discordance in marking normal appendix. Different structures are marked at different levels in same patient and at same acquisition.

 

Figure 8
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  		Fig. 3B —60-year-old man undergoing evaluation for cancer diagnosis. Transverse unenhanced CT scans show organ marked as appendix by reader A at first reading session (A–D) and at second reading session (E–H). Case is example of intrareader discordance in marking normal appendix. Different structures are marked at different levels in same patient and at same acquisition.

 

Figure 9
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  		Fig. 3C —60-year-old man undergoing evaluation for cancer diagnosis. Transverse unenhanced CT scans show organ marked as appendix by reader A at first reading session (A–D) and at second reading session (E–H). Case is example of intrareader discordance in marking normal appendix. Different structures are marked at different levels in same patient and at same acquisition.

 

Figure 10
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  		Fig. 3D —60-year-old man undergoing evaluation for cancer diagnosis. Transverse unenhanced CT scans show organ marked as appendix by reader A at first reading session (A–D) and at second reading session (E–H). Case is example of intrareader discordance in marking normal appendix. Different structures are marked at different levels in same patient and at same acquisition.

 

Figure 11
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  		Fig. 3E —60-year-old man undergoing evaluation for cancer diagnosis. Transverse unenhanced CT scans show organ marked as appendix by reader A at first reading session (A–D) and at second reading session (E–H). Case is example of intrareader discordance in marking normal appendix. Different structures are marked at different levels in same patient and at same acquisition.

 

Figure 12
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  		Fig. 3F —60-year-old man undergoing evaluation for cancer diagnosis. Transverse unenhanced CT scans show organ marked as appendix by reader A at first reading session (A–D) and at second reading session (E–H). Case is example of intrareader discordance in marking normal appendix. Different structures are marked at different levels in same patient and at same acquisition.

 

Figure 13
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  		Fig. 3G —60-year-old man undergoing evaluation for cancer diagnosis. Transverse unenhanced CT scans show organ marked as appendix by reader A at first reading session (A–D) and at second reading session (E–H). Case is example of intrareader discordance in marking normal appendix. Different structures are marked at different levels in same patient and at same acquisition.

 

Figure 14
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  		Fig. 3H —60-year-old man undergoing evaluation for cancer diagnosis. Transverse unenhanced CT scans show organ marked as appendix by reader A at first reading session (A–D) and at second reading session (E–H). Case is example of intrareader discordance in marking normal appendix. Different structures are marked at different levels in same patient and at same acquisition.

 

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