OBJECTIVES: To evaluate an algorithm integrating ultrasound and low-dose unenhanced CT with oral contrast medium (LDCT) in the assessment of acute appendicitis, to reduce the need of conventional CT. METHODS: Ultrasound was performed upon admission in 183 consecutive adult patients (111 women, 72 men, mean age 32) with suspicion of acute appendicitis and a BMI between 18.5 and 30 (step 1). No further examination was recommended when ultrasound was positive for appendicitis, negative with low clinical suspicion, or demonstrated an alternative diagnosis. All other patients underwent LDCT (30 mAs) (step 2). Standard intravenously enhanced CT (180 mAs) was performed after indeterminate LDCT (step 3). RESULTS: No further imaging was recommended after ultrasound in 84 (46%) patients; LDCT was obtained in 99 (54%). LDCT was positive or negative for appendicitis in 81 (82%) of these 99 patients, indeterminate in 18 (18%) who underwent standard CT. Eighty-six (47%) of the 183 patients had a surgically proven appendicitis. The sensitivity and specificity of the algorithm were 98.8% and 96.9%. CONCLUSIONS: The proposed algorithm achieved high sensitivity and specificity for detection of acute appendicitis, while reducing the need for standard CT and thus limiting exposition to radiation and to intravenous contrast media.
OBJECTIVES: To evaluate an algorithm integrating ultrasound and low-dose unenhanced CT with oral contrast medium (LDCT) in the assessment of acute appendicitis, to reduce the need of conventional CT. METHODS: Ultrasound was performed upon admission in 183 consecutive adult patients (111 women, 72 men, mean age 32) with suspicion of acute appendicitis and a BMI between 18.5 and 30 (step 1). No further examination was recommended when ultrasound was positive for appendicitis, negative with low clinical suspicion, or demonstrated an alternative diagnosis. All other patients underwent LDCT (30 mAs) (step 2). Standard intravenously enhanced CT (180 mAs) was performed after indeterminate LDCT (step 3). RESULTS: No further imaging was recommended after ultrasound in 84 (46%) patients; LDCT was obtained in 99 (54%). LDCT was positive or negative for appendicitis in 81 (82%) of these 99 patients, indeterminate in 18 (18%) who underwent standard CT. Eighty-six (47%) of the 183 patients had a surgically proven appendicitis. The sensitivity and specificity of the algorithm were 98.8% and 96.9%. CONCLUSIONS: The proposed algorithm achieved high sensitivity and specificity for detection of acute appendicitis, while reducing the need for standard CT and thus limiting exposition to radiation and to intravenous contrast media.
Authors: Alexandra Platon; Helmi Jlassi; Olivier T Rutschmann; Christoph D Becker; Francis R Verdun; Pascal Gervaz; Pierre-Alexandre Poletti Journal: Eur Radiol Date: 2008-09-17 Impact factor: 5.315
Authors: Sorapop Kiatpongsan; Lesley Meng; Jonathan D Eisenberg; Maurice Herring; Laura L Avery; Chung Yin Kong; Pari V Pandharipande Journal: Radiology Date: 2014-07-01 Impact factor: 11.105
Authors: Frederick Thurston Drake; Michael G Florence; Morris G Johnson; Gregory J Jurkovich; Steve Kwon; Zeila Schmidt; Richard C Thirlby; David R Flum Journal: Ann Surg Date: 2012-10 Impact factor: 12.969
Authors: Ji Ye Sim; Hyuk Jung Kim; Jae Woo Yeon; Byoung Sun Suh; Ki Ho Kim; Young Rock Ha; So Ya Paik Journal: Eur Radiol Date: 2013-02-08 Impact factor: 5.315