Using unenhanced helical CT with enteric contrast material for suspected appendicitis in patients treated at a community hospital.
OBJECTIVE
We evaluated the accuracy of unenhanced helical CT with enteric contrast material in the diagnosis of appendicitis in children and adults treated at a community hospital.


METHODS
Over an 8-month period, 100 consecutive patients with right lower quadrant pain and suspected appendicitis were prospectively evaluated. Thin-collimation helical CT scanning was performed after administration of enteric contrast material. CT interpretations were correlated with surgical pathology (45 patients) and clinical follow-up (55 patients).


RESULTS
The findings of 33 CT scans were interpreted as positive for appendicitis (29 true-positives and four false-positives), and the findings of 67 were interpreted as negative for appendicitis (66 true-negatives and one false-negative). Sensitivity was 97%, specificity was 94%, accuracy was 95%, positive predictive value was 88%, and negative predictive value was 99%. In the 67 CT scans with negative findings for appendicitis, an alternative diagnosis was made for 36 patients (54%).


CONCLUSIONS
Unenhanced helical CT with enteric contrast material for the evaluation of appendicitis can be implemented in a community hospital. In our study, such imaging achieved excellent accuracy.
Hawaii Radiologic Associates, Hilo 96720, USA.
B
B
Funaki
S R
SR
Grosskreutz
C N
CN
Funaki
D000328:Adult; D001064:Appendicitis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002648:Child; D003287:Contrast Media; D003974:Diatrizoate Meglumine; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D003974:Diatrizoate Meglumine