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The value of unenhanced CT in the diagnosis of acute appendicitis
G D'lppolito1, G G de Mello, J Szejnfeld
1Hospital São Paulo, Universidade Federal de São Paulo/Escola Paulista de Medicina, Brazil.
Objective:
To establish the accuracy of unenhanced CT in the preoperative diagnosis of acute appendicitis.
Design:
Accuracy study, prospective and blinded.
Setting:
The University Hospital.
Participants:
52 patients with clinical and laboratorial manifestations of acute appendicitis. CT diagnosis was made by: presence of an abnormal appendix, appendiceal calculi with pericecal phlegmon or alterations in the pericecal appendicular site and absence of signs that may lead to other diagnosis.
Main Outcome Measures:
Overall accuracy, comparing the tomographic aspects with the intra-operative findings and pathological reports ("gold standard").
Results:
Acute appendicitis was confirmed in 44 cases. Efficacy was 92%, sensitivity was 91%, specificity was 100%, positive predictive value was 100% and negative predictive value was 67%.
Conclusions:
Unenhanced CT presents a similar overall accuracy to that reported by other authors who studied enhanced CT diagnosis of acute appendicitis.