title: Enhanced multidetector-row computed tomography (MDCT) in the diagnosis of acute appendicitis and its severity.
abstract: 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.
authors: Department of Radiology, Sendai Citizen Hospital, Japan.
authors: Tesshou
authors: T
authors: Miki
authors: Seiji
authors: S
authors: Ogata
authors: Mitsunobu
authors: M
authors: Uto
authors: Toshihiro
authors: T
authors: Nakazono
authors: Miyuki
authors: M
authors: Urata
authors: Ryouhei
authors: R
authors: Ishibe
authors: Shin
authors: S
authors: Shinyama
authors: Masayuki
authors: M
authors: Nakajo
mesh_terms: 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*