Stratified computed tomography findings improve diagnostic accuracy for appendicitis.

Area of Science:

• Radiology
• Gastroenterology
• Surgical Diagnostics

Background:

• Accurate diagnosis of appendicitis is crucial for timely treatment.
• Computed tomography (CT) is a key imaging modality, but results can be equivocal.
• Improving diagnostic accuracy in equivocal CT findings for appendicitis is essential.

Purpose of the Study:

• To enhance the diagnostic accuracy of appendicitis in patients with non-conclusive computed tomography (CT) findings.
• To identify specific CT features that improve appendicitis diagnosis.

Main Methods:

• Retrospective review of 224 patients with suspected appendicitis and negative or equivocal CT scans.
• Categorization into pathologically proven appendicitis (n=177) and non-appendicitis (n=47) groups.
• Re-evaluation of CT images for characteristic features and comparison between groups.

Main Results:

• Significant differences observed in appendiceal diameter, periappendiceal fat stranding, and intraluminal air between groups.
• Appendicitis group showed larger diameter (>6.0 mm), more fat stranding, and less intraluminal air.
• Presence of two or more factors increased odds ratio for appendicitis by 6.8 times (P < 0.001).

Conclusions:

• Appendiceal diameter, fat stranding, and absence of intraluminal air are valuable indicators.
• These CT features improve diagnostic accuracy for appendicitis with equivocal findings.
• Enhanced CT interpretation aids in better clinical decision-making for suspected appendicitis.