Diagnosis of appendiceal diverticulitis by multidetector computed tomography

Area of Science:

• Radiology
• Gastroenterology
• Surgical Pathology

Background:

• Appendiceal diverticulitis (AD) presents a significant risk of perforation.
• Accurate diagnosis of AD is crucial for patients with suspected acute appendicitis (AA).
• Computed tomography (CT) is a primary imaging modality for diagnosing abdominal pathologies.

Purpose of the Study:

• To identify characteristic CT imaging findings specific to appendiceal diverticulitis (AD).
• To determine the diagnostic accuracy (sensitivity and specificity) of CT for AD.

Main Methods:

• Comparative analysis of CT images from patients with histopathologically confirmed AD (n=23) and AA (n=365).
• Evaluation of specific CT features differentiating AD from AA.
• Calculation of sensitivity and specificity for CT in diagnosing AD.

Main Results:

• Univariate analysis indicated a smaller maximal appendix diameter in AD compared to AA.
• Multivariate analysis identified saccular appendix wall structure, cecum/ascending colon diverticulum, and peri-appendiceal/cecal fluid collection as independent indicators of AD.
• The saccular appendix wall structure was the most specific finding for AD.

Conclusions:

• CT findings such as saccular appendix wall structure, cecum/ascending colon diverticulum, and peri-appendiceal/cecal fluid collection suggest AD in patients with suspected AA.
• CT demonstrated a sensitivity of 48% and a specificity of 99% for diagnosing AD.