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Why can we not see a normal appendix on CT? An evaluation of the factors influencing nonvisualization of a normal

Hyun Cheol Kim1, Dal Mo Yang, Hyun Phil Shin

  • 1Department of Radiology, East-West Neo Medical Center, Kyung-Hee University, Gangdong-Gu, Seoul, Republic of Korea. khcppp@lycos.co.kr

Clinical Imaging
|January 13, 2009
PubMed
Abstract

Insights

A low cecum, minimal pericecal fat, and fluid presence prevent normal appendix visualization on 64-slice MDCT. Non-identification of the ileocecal valve also impacts appendix visibility in CT scans.

Area of Science:

  • Radiology
  • Medical Imaging
  • Gastrointestinal Imaging

Background:

  • The appendix is often not visualized on CT scans.
  • Identifying factors for non-visualization is crucial for accurate diagnosis.

Purpose of the Study:

  • To determine factors hindering normal appendix visualization using 64-slice multi-detector computed tomography (MDCT).

Main Methods:

  • Retrospective analysis of 39 patients with non-visualized normal appendix and 100 controls.
  • Radiologists assessed MDCT for cecum level, pericecal fat, fluid, small bowel dilatation, cecal thickening, and ileocecal valve identification.

Main Results:

  • Non-visualized appendix associated with lower cecum level, minimal pericecal fat, and presence of pericecal fluid (P<.01).
  • Ileocecal valve non-identification was more frequent in non-visualized appendix cases (76.9% vs. 100%, P<.01).
  • Small bowel dilatation and cecal thickening showed no significant difference.

Conclusions:

  • Low cecum level, minimal pericecal fat, pericecal fluid, and non-identification of the ileocecal valve are key factors for non-visualization of a normal appendix on MDCT.
  • These findings aid in interpreting abdominal CT scans where the appendix is not seen.

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