Alvarado scores and pain onset in relation to multislice CT findings in acute appendicitis.
OBJECTIVE
To determine the correlation between clinical and multislice computed tomography (MSCT) findings of early- and late-stage acute appendicitis.


METHODS
The study was conducted between June 2003 and February 2006 with 143 patients. Patients were divided into 3 groups according to Alvarado scores: group 1 (n = 18; 13%; score: 1-4), group 2 (n = 70; 49%; score: 5-7), and group 3 (n = 55; 38%; score: 8-10). Abdominal MSCT results were compared to histopathological diagnoses. Patients were then divided into 2 other groups according to pain onset (MSCT performed within the first 12 h of pain onset and MSCT performed thereafter).


RESULTS
Histopathological findings were normal in 13 of the 143 patients (9%). The positive predictive value of MSCT did not significantly differ between the 3 Alvarado groups (92.8% in group 1, 95.1% in group 2, and 98.0% in group 3). Additionally, the positive predictive value of MSCT did not differ whether the scans were performed within the first 12 h of pain onset or thereafter (88% and 89%, respectively; P = 0.89).


CONCLUSIONS
MSCT should be performed even in patients in whom the clinical suspicion of appendicitis is low. MSCT is effective in patients with early-stage appendicitis.
Yildirim
Erkan
E
Department of Radiology, Başkent University School of Medicine, Ankara, Turkey. drerkany@yahoo.com
Karagülle
Erdal
E
Kirbaş
Ismail
I
Türk
Emin
E
Hasdoğan
Bariş
B
Tekşam
Mehmet
M
Coşkun
Mehmet
M
D015746:Abdominal Pain; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001064:Appendicitis / Q000145:classification / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed