| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Gastrointestinal Imaging |
1 From the Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215. From the 1999 RSNA scientific assembly. Received September 2, 1999; revision requested October 14; final revision received January 20, 2000; accepted February 1. Address correspondence to S.N.G. (e-mail: sgoldber@caregroup.harvard.edu).
PURPOSE: To determine the value of standard, nonfocused computed tomography (CT) in examining patients with right lower quadrant (RLQ) pain and suspected appendicitis.
MATERIALS AND METHODS: The CT scans and medical records of 100 consecutive patients who presented to the emergency department with RLQ pain and were clinically suspected of having appendicitis were retrospectively reviewed. Helical CT of both the abdomen and pelvis was performed at 7-mm increments after oral and intravenous contrast material administration. CT scans were evaluated for the presence of appendiceal or other disease. Results were correlated with surgical and pathologic findings in 34 patients or with 3-month clinical follow-up in 66 patients.
RESULTS: CT depicted abnormalities in 66 patients (66%). In 59 (59%) patients, the abnormality was located in the pelvis; 23 (39%) of these patients had appendicitis. Seven (7%) patients had abnormalities outside of the pelvis, a region not typically scanned during focused appendiceal imaging. Four of these seven patients required surgery. Thus, if only pelvic focused RLQ CT had been performed, overall sensitivity would have decreased from 99% to 88% (P < .05) and sensitivity for cases necessitating surgery would have decreased from 96% to 82% (P < .05).
CONCLUSION: Both abdominal and pelvic CT examinations are necessary to increase sensitivity and identify the many possible causes of RLQ pain in patients with clinically suspected appendicitis.
Index terms: Abdomen, acute conditions, 751.291 • Abdomen, CT, 78.12112, 78.12114, 78.12115, 78.12118 • Appendicitis, 751.291 • Pelvis, CT, 88.12112, 88.12114, 88.12115, 88.12118 • Uterine neoplasms, 85.3117, 85.313, 85.315
This article has been cited by other articles:
|
|
 |
|
  H. Seo, K. H. Lee, H. J. Kim, K. Kim, S.-B. Kang, S. Y. Kim, and Y. H. Kim Diagnosis of Acute Appendicitis With Sliding Slab Ray-Sum Interpretation of Low-Dose Unenhanced CT and Standard-Dose IV Contrast-Enhanced CT Scans Am. J. Roentgenol., July 1, 2009; 193(1): 96 - 105. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. van Randen, S. Bipat, A. H. Zwinderman, D. T. Ubbink, J. Stoker, and M. A. Boermeester Acute Appendicitis: Meta-Analysis of Diagnostic Performance of CT and Graded Compression US Related to Prevalence of Disease Radiology, October 1, 2008; 249(1): 97 - 106. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Tsuboi, K. Takase, I. Kaneda, T. Ishibashi, T. Yamada, M. Kitami, S. Higano, and S. Takahashi Perforated and Nonperforated Appendicitis: Defect in Enhancing Appendiceal Wall Depiction with Multi Detector Row CT Radiology, January 1, 2008; 246(1): 142 - 147. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E M Anderson and H K Bungay Imaging investigation of acute right iliac fossa pain Imaging, December 1, 2006; 18(4): 257 - 267. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. S. Doria, R. Moineddin, C. J. Kellenberger, M. Epelman, J. Beyene, S. Schuh, P. S. Babyn, and P. T. Dick US or CT for Diagnosis of Appendicitis in Children and Adults? A Meta-Analysis Radiology, October 1, 2006; 241(1): 83 - 94. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Ganguli, V. Raptopoulos, F. Komlos, B. Siewert, and J. B. Kruskal Right Lower Quadrant Pain: Value of the Nonvisualized Appendix in Patients at Multidetector CT Radiology, October 1, 2006; 241(1): 175 - 180. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Pinto Leite, J. M. Pereira, R. Cunha, P. Pinto, and C. Sirlin CT Evaluation of Appendicitis and Its Complications: Imaging Techniques and Key Diagnostic Findings Am. J. Roentgenol., August 1, 2005; 185(2): 406 - 417. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. P. Daly, R. H. Cohan, I. R. Francis, E. M. Caoili, J. H. Ellis, and B. Nan Incidence of Acute Appendicitis in Patients with Equivocal CT Findings Am. J. Roentgenol., June 1, 2005; 184(6): 1813 - 1820. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. K. Paulson, J. P. Harris, T. A. Jaffe, P. A. Haugan, and R. C. Nelson Acute Appendicitis: Added Diagnostic Value of Coronal Reformations from Isotropic Voxels at Multi-Detector Row CT Radiology, June 1, 2005; 235(3): 879 - 885. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Foley, F. Earnest IV, M. A. Nathan, D. M. Hough, H. J. Schiller, and T. L. Hoskin Differentiation of Nonperforated from Perforated Appendicitis: Accuracy of CT Diagnosis and Relationship of CT Findings to Length of Hospital Stay Radiology, April 1, 2005; 235(1): 89 - 96. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kaiser, T. Finnbogason, H. K. Jorulf, E. Soderman, and B. Frenckner Suspected Appendicitis in Children: Diagnosis with Contrast-enhanced versus Nonenhanced Helical CT Radiology, May 1, 2004; 231(2): 427 - 433. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Siewert, V. Raptopoulos, S.-I. Liu, R. A. Hodin, R. B. Davis, and M. P. Rosen CT Predictors of Failed Laparoscopic Appendectomy Radiology, November 1, 2003; 229(2): 415 - 420. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Raptopoulos, G. Katsou, M. P. Rosen, B. Siewert, S. N. Goldberg, and J. B. Kruskal Acute Appendicitis: Effect of Increased Use of CT on Selecting Patients Earlier Radiology, February 1, 2003; 226(2): 521 - 526. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. K. Paulson, M. F. Kalady, and T. N. Pappas Suspected Appendicitis N. Engl. J. Med., January 16, 2003; 348(3): 236 - 242. [Full Text] [PDF]
|
|
|
|
|
|
S. H. Ahn, W. W. Mayo-Smith, B. L. Murphy, S. E. Reinert, and J. J. Cronan Acute Nontraumatic Abdominal Pain in Adult Patients: Abdominal Radiography Compared with CT Evaluation Radiology, October 1, 2002; 225(1): 159 - 164. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P J Shorvon Imaging of appendicitis: a cautionary note Br. J. Radiol., September 1, 2002; 75(897): 717 - 720. [Full Text] [PDF]
|
|
|
|
|
|
G Ege, H Akman, A Sahin, D Bugra, and K Kuzucu Diagnostic value of unenhanced helical CT in adult patients with suspected acute appendicitis Br. J. Radiol., September 1, 2002; 75(897): 721 - 725. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. S. Raman, D. S. K. Lu, B. M. Kadell, D. J. Vodopich, J. Sayre, and H. Cryer Accuracy of Nonfocused Helical CT for the Diagnosis of Acute Appendicitis: A 5-Year Review Am. J. Roentgenol., June 1, 2002; 178(6): 1319 - 1325. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Macari, J. Hines, E. Balthazar, and A. Megibow Mesenteric Adenitis: CT Diagnosis of Primary Versus Secondary Causes, Incidence, and Clinical Significance in Pediatric and Adult Patients Am. J. Roentgenol., April 1, 2002; 178(4): 853 - 858. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. R. Fefferman, K. J. Roche, L. P. Pinkney, M. M. Ambrosino, and N. B. Genieser Suspected Appendicitis in Children: Focused CT Technique for Evaluation Radiology, September 1, 2001; 220(3): 691 - 695. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Wijetunga, B. S. Tan, J. C. Rouse, G. W. Bigg-Wither, and B. D. Doust Diagnostic Accuracy of Focused Appendiceal CT in Clinically Equivocal Cases of Acute Appendicitis Radiology, December 1, 2001; 221(3): 747 - 753. [Abstract] [Full Text] [PDF]
|
|
