Can outer-to-outer diameter be used alone in diagnosing appendicitis on 128-slice MDCT?

Area of Science:

• Radiology
• Medical Imaging
• Gastrointestinal Imaging

Background:

• Accurate visualization of the normal appendix is crucial for diagnosing appendicitis.
• Multidetector computed tomography (MDCT) offers advanced imaging capabilities for abdominal structures.
• Understanding normal appendiceal parameters on MDCT is essential for differentiating pathology.

Purpose of the Study:

• To evaluate the visualization rate of the normal appendix using 128-slice MDCT.
• To assess the typical position and diameter of the normal appendix in an adult population.
• To determine the utility of MDCT in visualizing appendiceal anatomy.

Main Methods:

• Retrospective analysis of 98 adult patients undergoing non-enhanced MDCT of the abdomen and pelvis.
• Review of both axial and coronal reformatted images by two blinded radiologists.
• Assessment of appendix visualization frequency, position, diameter, and luminal contents.

Main Results:

• The normal appendix was visualized in 99% of the study cohort.
• The mean outer-to-outer diameter of the appendix measured 5.6 ± 1.3 mm (range 3.0–11.0 mm).
• Significant variability in appendiceal position and diameter was observed.

Conclusions:

• 128-slice MDCT, particularly with multiplanar reformation, provides excellent visualization of the normal appendix.
• Normal appendiceal diameter exhibits considerable variation, necessitating caution in diagnosing appendicitis based solely on this parameter.
• MDCT is a valuable tool for assessing normal appendiceal anatomy, aiding in differential diagnosis.