Enhanced multidetector-row computed tomography (MDCT) in the diagnosis of acute appendicitis and its severity.
OBJECTIVE
To examine the accuracy of enhanced multidetector-row computed tomography (MDCT) in diagnosing acute appendicitis and its severity.


METHODS
Contrast-enhanced MD-CT 3.5 mm thick images of 23 control patients (A), and 64 patients with surgically proven acute appendicitis including 8 catarrhal (B), 28 phlegmonous (C), and 28 gangrenous (D) appendicitis patients were respectively analyzed.


RESULTS
The number of observed major computed tomography (CT) findings for each patient group were as follows: enlarged (> or = 6 mm in maximum diameter) appendix (A: 5, B: 8, C: 28, D: 28), enhancement of the appendiceal wall; hyper (A: 3, B: 8, C: 27, D: 20), iso (A: 15, B: 0, C: 1, D: 2), hypo (A-C: 0, D: 4), and patched (A-C: 0, D: 2) enhancement, appendicolith (A, B: 0, C: 7, D: 13), dirty fat sign (A: 3, B: 1, C: 21, D: 28), localized ascites (A: 2, B: 0, C: 2, D: 11), and abscess formation (A-C: 0, D: 5). From the combinations of these findings, we could differentiate acute appendicitis from the control normal appendix with an accuracy of 99% and could diagnose the severity of acute appendicitis with accuracies of 92% for catarrhal appendicitis, 84% for phlegmonous appendicitis, and 92% for gangrenous appendicitis. We could also visually reconstruct the entire forms and positions of the appendices from the successive CT findings because of the high-resolution thin-slice MDCT images.


CONCLUSIONS
MDCT is highly accurate in the diagnosis of acute appendicitis and its severity.
Miki
Tesshou
T
Department of Radiology, Sendai Citizen Hospital, Japan.
Ogata
Seiji
S
Uto
Mitsunobu
M
Nakazono
Toshihiro
T
Urata
Miyuki
M
Ishibe
Ryouhei
R
Shinyama
Shin
S
Nakajo
Masayuki
M
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001064:Appendicitis / Q000145:classification / Q000000981:diagnostic imaging*; D001065:Appendix / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods*