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Diagnosis of Acute Appendicitis With Sliding Slab Ray-Sum Interpretation of Low-Dose Unenhanced CT and Standard-Dose IV Contrast-Enhanced CT Scans

Hyobin Seo1, Kyoung Ho Lee1, Hyuk Jung Kim2, Kyuseok Kim3, Sung-Bum Kang4, So Yeon Kim1 and Young Hoon Kim1

1 Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea.
2 Department of Radiology, Seoul Medical Center, Seoul, Korea.
3 Department of Emergency Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Korea.
4 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Korea.


Figure 1
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Fig. 1 Flow diagram shows two radiologists' rating results for likelihood of appendicitis. Data in parentheses are numbers of patients confirmed to have appendicitis.

 

Figure 2
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Fig. 2A 21-year-old woman with acute appendicitis and body mass index of 17.4. Low-dose unenhanced (A and B) and standard-dose IV contrast-enhanced (C and D) transverse CT scans show enlarged appendix (solid arrows) containing air and appendicolith (open arrows, B and D). Two readers assigned score of 5 for presence of appendicitis on both types of scan. See also Figure S2C and S2D, cine loops, in supplemental data online.

 

Figure 3
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Fig. 2B 21-year-old woman with acute appendicitis and body mass index of 17.4. Low-dose unenhanced (A and B) and standard-dose IV contrast-enhanced (C and D) transverse CT scans show enlarged appendix (solid arrows) containing air and appendicolith (open arrows, B and D). Two readers assigned score of 5 for presence of appendicitis on both types of scan. See also Figure S2C and S2D, cine loops, in supplemental data online.

 

Figure 4
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Fig. 2C 21-year-old woman with acute appendicitis and body mass index of 17.4. Low-dose unenhanced (A and B) and standard-dose IV contrast-enhanced (C and D) transverse CT scans show enlarged appendix (solid arrows) containing air and appendicolith (open arrows, B and D). Two readers assigned score of 5 for presence of appendicitis on both types of scan. See also Figure S2C and S2D, cine loops, in supplemental data online.

 

Figure 5
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Fig. 2D 21-year-old woman with acute appendicitis and body mass index of 17.4. Low-dose unenhanced (A and B) and standard-dose IV contrast-enhanced (C and D) transverse CT scans show enlarged appendix (solid arrows) containing air and appendicolith (open arrows, B and D). Two readers assigned score of 5 for presence of appendicitis on both types of scan. See also Figure S2C and S2D, cine loops, in supplemental data online.

 

Figure 6
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Fig. 3A 31-year-old man with appendicitis and BMI of 31.3. Low-dose unenhanced (A) and standard-dose IV contrast-enhanced (B) transverse CT scans show enlarged appendix (solid arrow) and increased attenuation of mesoappendiceal fat (open arrow). Two readers assigned score of 5 for presence of appendicitis at both types of scan. See also Figures S3C and S3D, cine loops, in supplemental data online.

 

Figure 7
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Fig. 3B 31-year-old man with appendicitis and BMI of 31.3. Low-dose unenhanced (A) and standard-dose IV contrast-enhanced (B) transverse CT scans show enlarged appendix (solid arrow) and increased attenuation of mesoappendiceal fat (open arrow). Two readers assigned score of 5 for presence of appendicitis at both types of scan. See also Figures S3C and S3D, cine loops, in supplemental data online.

 

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