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Pediatric Imaging |
1 From the Departments of Radiology (C.J.S., K.E.A., V.J.B., S.C.B., S.C.M., M.T.M., D.M.W.) and Surgery (D.L.D., A.S., E.R.G.), Rainbow Babies and Children’s Hospital of the University Hospitals of Cleveland and Case Western Reserve School of Medicine, 11100 Euclid Ave, Cleveland, OH 44106-5056. Received August 11, 1999; revision requested September 17; final revision received December 7; accepted December 13. Address correspondence to C.J.S. (e-mail: sivit@uhrad.com).
PURPOSE: To evaluate the accuracy of helical computed tomography (CT) for the diagnosis of appendicitis in children and to assess the utility of CT in establishing alternative diagnoses.
MATERIALS AND METHODS: The medical records of 154 children (median age, 12 years; age range, 1–20 years) who were suspected to have appendicitis and who underwent CT were reviewed. The gastrointestinal tract was opacified in 151 of 154 patients: Only orally administered contrast material was used in 126 patients; only rectally administered contrast material, in 21 patients; and both oral and rectal contrast material, in four patients. CT findings were correlated with surgical and histopathologic findings or with clinical follow-up findings.
RESULTS: Sixty-four CT scans were interpreted as positive for appendicitis and included 58 true-positive and six false-positive scans. Ninety scans were interpreted as negative and included 87 true-negative and three false-negative scans. CT had a sensitivity of 95% and a specificity of 94% for the diagnosis of appendicitis. In addition, in 32 (34%) of 93 patients without appendicitis, an alternative diagnosis was established on the basis of CT findings.
CONCLUSION: Helical CT is useful in a pediatric population to diagnose or exclude appendicitis and to establish an alternative diagnosis.
Index terms: Appendicitis, 751.291 • Appendix, CT, 751.12112, 751.12115 • Children, gastrointestinal tract, 751.291
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