[Is appendicolith a reliable sign for acute appendicitis at MDCT?].
OBJECTIVE
To determine the frequency of detection of appendicoliths on normal appendix at multidetector row computed tomography (MDCT) with multiplanar reconstructions (MPR).


METHODS
A senior radiologist, blinded to patient's surgical history, prospectively and independently reviewed abdominopelvic MDCT scans in 57 consecutive adult patients without symptoms suggesting appendicitis. Most patients had IV iodine injection, but no oral contrast. Thick (5 mm) and thin (1 mm) slices were analyzed on a workstation. MPR were available. Localization of the appendix, overall diameter, intraluminal gas and appendicolith were recorded.


RESULTS
The appendix was visualized in 47/57 (82%). An appendicolith was found in 13%. Intraluminal gas was identified in 87%. The localization was retrocaecal (47%), mediocaecal (21%) or pelvic (32%). The mean overall diameter of the normal appendix was 6.7 mm +/- 1.2 (SD).


CONCLUSIONS
Appendicolith was found in a significant number of normal patients at MDCT and don't represent a specific sign for appendicitis.
Huwart
L
L
Service de Radiologie, Hôpital de Bicêtre, 78 rue du Général Leclerc 94275 Le Kremlin Bicêtre cedex. huwart.laurent@wanadoo.fr
El Khoury
M
M
Lesavre
A
A
Phan
C
C
Rangheard
A-S
AS
Bessoud
B
B
Menu
Y
Y
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000150:complications* / Q000000981:diagnostic imaging*; D005244:Fecal Impaction / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods