Evaluation of women with possible appendicitis using technetium-99m leukocyte scan.
The authors evaluated the use of technetium-99m albumin colloid white blood cell (TAC-WBC) scan in women with possible appendicitis. One hundred and nine women underwent 110 TAC-WBC scans. One woman had a second scan on a separate admission and was considered two individual patients in the analysis. Twenty-six women had appendicitis, 10 of whom had a perforated appendix at surgery. The TAC-WBC scan was indeterminate (abnormal but nondiagnostic for appendicitis) in 52 women (47%), nine of whom had appendicitis. Fifty-eight scans were read as positive or negative for appendiceal pathology. There were 16 true positives, 5 false positives, 36 true negatives, and 1 false negative. The predictive value of a positive scan was 76%, and the predictive value of a negative scan was 97%. The TAC-WBC scan was positive in 62% of patients with appendicitis and negative in 43% of the patients without appendicitis resulting in an overall accuracy of 47% in the 109 women. The main value of TAC-WBC scan in women with possible appendicitis is its high negative predictive value and the main problem with the TAC-WBC scan is its high indeterminate rate.
Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance 90509.
P L
PL
Henneman
C S
CS
Marcus
J A
JA
Butler
T A
TA
Hall
T M
TM
Koci
N
N
Worthen
S E
SE
Wilson
D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000150:complications / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D006801:Humans; D007962:Leukocytes; D008875:Middle Aged; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D013668:Technetium Tc 99m Aggregated Albumin; D014463:Ultrasonography
D013668:Technetium Tc 99m Aggregated Albumin