OBJECTIVE: To compare the sensitivity and specificity of unenhanced spiral computed tomography (CT) and ultrasonography (US) in patients with suspected acute appendicitis. DESIGN: Prospective study. SETTING: University hospital, Germany. SUBJECTS: 120 consecutive patients with acute appendicitis as a differential diagnosis, whose clinical findings were not enough to make operation essential, but were too severe to send home. INTERVENTIONS: CT and US of the appendix. MAIN OUTCOME MEASURES: Sensitivity, specificity, and positive and negative predictive value. RESULTS: The results were correlated with surgical and histopathological findings at appendicectomy or clinical follow-up. 93 patients had acute appendicitis, 27 patients did not. The sensitivity of CT was 95% and of US 87%. The corresponding specificities were 89% and 74%, positive predictive values 97% and 92%, negative predictive values 83% and 63%. In the 27 patients who did not have acute appendicitis, the correct diagnosis was established with CT in 14 patients and with US in eight. CONCLUSION: CT is more sensitive and specific than US in patients suspected of having acute appendicitis, but in whom the presentation is equivocal. The use of unenhanced spiral CT led to a significant improvement in the accuracy of preoperative diagnosis and a lower negative appendicectomy rate.
OBJECTIVE: To compare the sensitivity and specificity of unenhanced spiral computed tomography (CT) and ultrasonography (US) in patients with suspected acute appendicitis. DESIGN: Prospective study. SETTING: University hospital, Germany. SUBJECTS: 120 consecutive patients with acute appendicitis as a differential diagnosis, whose clinical findings were not enough to make operation essential, but were too severe to send home. INTERVENTIONS: CT and US of the appendix. MAIN OUTCOME MEASURES: Sensitivity, specificity, and positive and negative predictive value. RESULTS: The results were correlated with surgical and histopathological findings at appendicectomy or clinical follow-up. 93 patients had acute appendicitis, 27 patients did not. The sensitivity of CT was 95% and of US 87%. The corresponding specificities were 89% and 74%, positive predictive values 97% and 92%, negative predictive values 83% and 63%. In the 27 patients who did not have acute appendicitis, the correct diagnosis was established with CT in 14 patients and with US in eight. CONCLUSION: CT is more sensitive and specific than US in patients suspected of having acute appendicitis, but in whom the presentation is equivocal. The use of unenhanced spiral CT led to a significant improvement in the accuracy of preoperative diagnosis and a lower negative appendicectomy rate.
Authors: Michael D Repplinger; Joseph F Levy; Erica Peethumnongsin; Megan E Gussick; James E Svenson; Sean K Golden; William J Ehlenbach; Ryan P Westergaard; Scott B Reeder; David J Vanness Journal: J Magn Reson Imaging Date: 2015-12-22 Impact factor: 4.813
Authors: Michael D Repplinger; Perry J Pickhardt; Jessica B Robbins; Douglas R Kitchin; Tim J Ziemlewicz; Scott J Hetzel; Sean K Golden; John B Harringa; Scott B Reeder Journal: Radiology Date: 2018-04-24 Impact factor: 11.105
Authors: John B Harringa; Rebecca L Bracken; B Keegan Markhardt; Timothy J Ziemlewicz; Meghan Lubner; Arthur Chiu; Jen Birstler; Perry J Pickhardt; Scott B Reeder; Michael D Repplinger Journal: Emerg Radiol Date: 2021-03-17
Authors: Sonja Kinner; Perry J Pickhardt; Erica L Riedesel; Kara G Gill; Jessica B Robbins; Douglas R Kitchin; Timothy J Ziemlewicz; John B Harringa; Scott B Reeder; Michael D Repplinger Journal: AJR Am J Roentgenol Date: 2017-08-10 Impact factor: 3.959