Evaluation of suspected appendicitis in children and young adults: helical CT.
OBJECTIVE
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.


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.


CONCLUSIONS
Helical CT is useful in a pediatric population to diagnose or exclude appendicitis and to establish an alternative diagnosis.
Departments of Radiology, Rainbow Babies and Children's Hospital of the University Hospitals of Cleveland and Case Western Reserve School of Medicine, Cleveland, OH 44106-5056, USA.
C J
CJ
Sivit
K E
KE
Applegate
S C
SC
Berlin
M T
MT
Myers
A
A
Stallion
D L
DL
Dudgeon
V J
VJ
Borisa
S C
SC
Morrison
D M
DM
Weinert
E R
ER
Grisoni
D000284:Administration, Oral; D000285:Administration, Rectal; D000293:Adolescent; D000328:Adult; D001064:Appendicitis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005069:Evaluation Studies as Topic; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007223:Infant; D007813:Laparotomy; D008297:Male; D011237:Predictive Value of Tests; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media