Abidin Kılınçer1, Erhan Akpınar2, Bülent Erbil3, Emre Ünal1, Ali Devrim Karaosmanoğlu1, Volkan Kaynaroğlu4, Deniz Akata1, Mustafa Özmen1. 1. Department of Radiology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara, 06100, Turkey. 2. Department of Radiology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara, 06100, Turkey. erhan.akpinar@gmail.com. 3. Department of Emergency Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey. 4. Department of General Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Abstract
OBJECTIVE: To determine the diagnostic accuracy of abdominal CT with compression to the right lower quadrant (RLQ) in adults with acute appendicitis. METHODS: 168 patients (age range, 18-78 years) were included who underwent contrast-enhanced CT for suspected appendicitis performed either using compression to the RLQ (n = 71) or a standard protocol (n = 97). Outer diameter of the appendix, appendiceal wall thickening, luminal content and associated findings were evaluated in each patient. Kruskal-Wallis, Fisher's and Pearson's chi-squared tests were used for statistical analysis. RESULTS: There was no significant difference in the mean outer diameter (MOD) between compression CT scans (10.6 ± 1.9 mm) and standard protocol (11.2 ± 2.3 mm) in patients with acute appendicitis (P = 1). MOD was significantly lower in the compression group (5.2 ± 0.8 mm) compared to the standard protocol (6.5 ± 1.1 mm) (P < 0.01) in patients without appendicitis. A cut-off value of 6.75 mm for the outer diameter of the appendix was found to be 100% sensitive in the diagnosis of acute appendicitis for both groups. The specificity was higher for compression CT technique (67.7 vs. 94.9%). CONCLUSION: Normal appendix diameter was significantly smaller in the compression-CT group compared to standard-CT group, increasing diagnostic accuracy of abdominal compression CT. KEY POINTS: • Normal appendix diameter is significantly smaller in compression CT. • Compression could force contrast material to flow through the appendiceal lumen. • Compression CT may be a CT counterpart of graded compression US.
OBJECTIVE: To determine the diagnostic accuracy of abdominal CT with compression to the right lower quadrant (RLQ) in adults with acute appendicitis. METHODS: 168 patients (age range, 18-78 years) were included who underwent contrast-enhanced CT for suspected appendicitis performed either using compression to the RLQ (n = 71) or a standard protocol (n = 97). Outer diameter of the appendix, appendiceal wall thickening, luminal content and associated findings were evaluated in each patient. Kruskal-Wallis, Fisher's and Pearson's chi-squared tests were used for statistical analysis. RESULTS: There was no significant difference in the mean outer diameter (MOD) between compression CT scans (10.6 ± 1.9 mm) and standard protocol (11.2 ± 2.3 mm) in patients with acute appendicitis (P = 1). MOD was significantly lower in the compression group (5.2 ± 0.8 mm) compared to the standard protocol (6.5 ± 1.1 mm) (P < 0.01) in patients without appendicitis. A cut-off value of 6.75 mm for the outer diameter of the appendix was found to be 100% sensitive in the diagnosis of acute appendicitis for both groups. The specificity was higher for compression CT technique (67.7 vs. 94.9%). CONCLUSION: Normal appendix diameter was significantly smaller in the compression-CT group compared to standard-CT group, increasing diagnostic accuracy of abdominal compression CT. KEY POINTS: • Normal appendix diameter is significantly smaller in compression CT. • Compression could force contrast material to flow through the appendiceal lumen. • Compression CT may be a CT counterpart of graded compression US.
Entities:
Keywords:
Abdominal CT; Acute appendicitis; Adults; Compression; Right lower quadrant
Authors: Aykut Bursali; Mehmet Araç; Ali Yusuf Oner; Halil Celik; Seçil Ekşioğlu; Terman Gümüş Journal: Diagn Interv Radiol Date: 2005-03 Impact factor: 2.630
Authors: Caroline P Daly; Richard H Cohan; Isaac R Francis; Elaine M Caoili; James H Ellis; Bin Nan Journal: AJR Am J Roentgenol Date: 2005-06 Impact factor: 3.959