Suspected acute appendicitis: nonenhanced helical CT in 300 consecutive patients

Area of Science:

• Radiology
• Medical Imaging

Background:

• Acute appendicitis is a common surgical emergency.
• Accurate diagnosis is crucial for timely intervention and preventing complications.

Purpose of the Study:

• To evaluate the diagnostic accuracy of nonenhanced helical computed tomography (CT) for suspected acute appendicitis.
• To determine if CT without contrast material can reliably confirm or exclude appendicitis.

Main Methods:

• A prospective study of 300 patients with suspected appendicitis.
• Thin-section, nonenhanced helical CT scans were performed without oral, intravenous, or rectal contrast.
• Diagnostic criteria included enlarged appendix (> 6 mm) and periappendiceal inflammation.

Main Results:

• The study achieved a sensitivity of 96% and a specificity of 99%.
• Overall diagnostic accuracy was 97%, with 110 true-positive and 181 true-negative diagnoses.
• Few false-negative (5) and false-positive (4) diagnoses were reported.

Conclusions:

• Nonenhanced helical CT is a highly accurate and effective method for diagnosing or excluding acute appendicitis.
• Clinical experience and understanding interpretation nuances can further enhance diagnostic performance.