The utility of unenhanced computed tomography in appendicitis in children

To evaluate the utility of unenhanced helical computed tomography (UHCT) in appendicitis in children, we performed a retrospective study of 112 consecutive patients. The radiologist's interpretation of the UHCT was compared with disease status using appendix pathology findings as the gold standard for diagnosis. The performance characteristics of UHCT were as follows: sensitivity 87.5% (95% CI: 75.8-94.8%), specificity 93.7% (95% CI: 85.4%-98.0%), positive predictive value 91.3% (95% CI: 83.2%-99.4%), negative predictive value 90.8% (95% CI: 83.7%-97.8%), overall diagnostic accuracy 90.9% (95% CI: 85.7-96.3%). Positive and negative likelihood ratios were 13.8 (95% CI: 5.3-35.8) and 0.13 (95% CI: 0.06-0.28), respectively. UHCT seems to be a very useful diagnostic test for the evaluation of childhood appendicitis when interpreted by experienced radiologists. The diagnostic accuracy of UHCT found in this study is comparable to that reported for contrast-enhanced CT as well as graded compression ultrasound in appendicitis in children.