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Suspected appendicitis in children: focused CT technique for evaluation.

N R Fefferman1, K J Roche, L P Pinkney

  • 1Department of Radiology, Division of Pediatric Radiology, New York University Medical Center, 560 First Ave, New York, NY 10016, USA. nfeff@aol.com

Radiology
|August 30, 2001
PubMed
Summary

A focused computed tomographic (CT) scan technique accurately diagnoses appendicitis. Limiting CT scans to the region below the right lower pole (RLP) maintains diagnostic accuracy for appendicitis.

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Area of Science:

  • Radiology
  • Pediatric Imaging
  • Abdominal Imaging

Background:

  • Appendicitis is a common surgical emergency in children.
  • Accurate diagnosis is crucial to avoid complications and unnecessary surgery.
  • Computed tomography (CT) is a key imaging modality for diagnosing appendicitis.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of a focused computed tomographic (CT) technique for appendicitis.
  • To assess if contrast-enhanced CT can be limited to specific abdominal regions for appendicitis diagnosis.

Main Methods:

  • Retrospective review of 93 contrast-enhanced CT scans in pediatric patients with right lower quadrant pain.
  • Analysis of CT findings based on anatomical regions: above RLP, between RLP and iliac crest, and below iliac crest.

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  • Calculation of sensitivity, specificity, and predictive values for appendicitis diagnosis.

    • Main Results:

    • The focused CT technique demonstrated high accuracy: 97% sensitivity, 93% specificity, 90% positive predictive value, and 98% negative predictive value.
    • Diagnostic findings for appendicitis were predominantly located below the iliac crest.
    • Limiting CT interpretation to focused images yielded results comparable to reviewing all images.

    Conclusions:

    • A focused CT technique, limited to the region below the right lower pole (RLP), is accurate for diagnosing appendicitis.
    • This focused approach can potentially reduce radiation exposure and scan time in pediatric appendicitis evaluation.