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Diagnostic performance of multidetector computed tomography for suspected acute appendicitis
Perry J Pickhardt1, Edward M Lawrence, B Dustin Pooler
1Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792-3252, USA. ppickhardt2@uwhealth.org
Annals of Internal Medicine
|June 22, 2011
Summary
Multidetector computed tomography (MDCT) is a highly accurate tool for diagnosing acute appendicitis in adults, demonstrating high sensitivity and specificity. This imaging technique aids in reducing negative appendectomy rates and identifying alternative diagnoses.
Area of Science:
- Radiology
- Surgical Pathology
- Emergency Medicine
Background:
- Preoperative computed tomography (CT) use for suspected acute appendicitis has significantly increased with multidetector CT (MDCT) scanner availability.
- MDCT scanners have become integral in modern diagnostic imaging for abdominal conditions.
Purpose of the Study:
- To evaluate the diagnostic performance of MDCT in adults with suspected acute appendicitis.
- Assess the accuracy of MDCT in identifying appendicitis and guiding clinical decisions.
Main Methods:
- Retrospective analysis of MDCT findings and clinical outcomes in 2871 adults with suspected appendicitis.
- MDCT scans were interpreted by radiologists aware of the study indication, with performance assessed against combined clinical, surgical, and pathology findings.
Main Results:
- MDCT demonstrated high diagnostic performance with 98.5% sensitivity and 98.0% specificity for acute appendicitis.
- The study indicated a potential decrease in negative appendectomy rates and a significant reduction in perforation rates over the study period (2000-2009).
- MDCT provided alternative diagnoses in 42.1% of patients without appendicitis.
Conclusions:
- Multidetector computed tomography is a valuable tool for the routine evaluation of suspected appendicitis in adults.
- Potential referral bias was noted, as cases with difficult clinical diagnoses might not have been referred for MDCT.
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