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DOI: 10.1148/radiol.2413051896
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Perforated versus Nonperforated Acute Appendicitis: Accuracy of Multidetector CT Detection1

Sarah D. Bixby, MD, Brian C. Lucey, MD, Jorge A. Soto, MD, Jens M. Theysohn, MD, Al Ozonoff, PhD and Jose C. Varghese, MD

1 From the Division of Body Imaging, Department of Radiology, Boston University Medical Center, Boston, Mass (S.D.B., B.C.L., J.A.S., J.M.T., J.C.V.); and Department of Biostatistics, Boston University School of Public Health, Boston, Mass (A.O.). From the 2005 RSNA Annual Meeting. Received November 21, 2005; revision requested January 11, 2006; revision received January 17; accepted February 6; final version accepted March 20. Address correspondence to S.D.B., Department of Radiology, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115 (e-mail: sarah.bixby{at}childrens.harvard.edu).


Figure 1
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  		Figure 1: Flow diagram of patient exclusions leading to selection of final study group. MDCT = multidetector CT.

 

Figure 2
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  		Figure 2: Transverse CT image enhanced with oral and intravenous contrast materials and obtained in 33-year-old woman who presented with right lower quadrant pain shows bubble of gas (arrow) close to tip of appendix but thought to lie outside of bowel. This appendix was not perforated at surgery.

 

Figure 3
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  		Figure 3: Transverse CT image enhanced with oral and intravenous contrast materials and obtained in 21-year-old man who presented with right lower quadrant pain shows enhancement defect (arrowhead) in appendiceal wall. This appendix was not perforated at surgery.

 

Figure 4
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  		Figure 4: Receiver operating characteristic curve derived from sensitivities and specificities of comprehensive CT scores. Dotted line represents curve for a test that is no better than chance. Continuous line represents curve derived from current study data. Area under curve was 0.812 (95% confidence interval: 0.741, 0.875) in current study.

 




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