title: Evaluation of a low-dose CT protocol with oral contrast for assessment of acute appendicitis.
abstract: The aim of this study was to evaluate a low-dose CT with oral contrast medium (LDCT) for the diagnosis of acute appendicitis and compare its performance with standard-dose i.v. contrast-enhanced CT (standard CT) according to patients' BMIs. Eighty-six consecutive patients admitted with suspicion of acute appendicitis underwent LDCT (30 mAs), followed by standard CT (180 mAs). Both examinations were reviewed by two experienced radiologists for direct and indirect signs of appendicitis. Clinical and surgical follow-up was considered as the reference standard. Appendicitis was confirmed by surgery in 37 (43%) of the 86 patients. Twenty-nine (34%) patients eventually had an alternative discharge diagnosis to explain their abdominal pain. Clinical and biological follow-up was uneventful in 20 (23%) patients. LDCT and standard CT had the same sensitivity (100%, 33/33) and specificity (98%, 45/46) to diagnose appendicitis in patients with a body mass index (BMI) >or= 18.5. In slim patients (BMI<18.5), sensitivity to diagnose appendicitis was 50% (2/4) for LDCT and 100% (4/4) for standard CT, while specificity was identical for both techniques (67%, 2/3). LDCT may play a role in the diagnostic workup of patients with a BMI >or= 18.5.
authors.affiliation: Department of Radiology, University Hospital of Geneva, 24, rue Micheli-du-Crest, 1211 Geneva 14, Switzerland.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Platon
authors.forename: Helmi
authors.initials: H
authors.lastname: Jlassi
authors.forename: Olivier T
authors.initials: OT
authors.lastname: Rutschmann
authors.forename: Christoph D
authors.initials: CD
authors.lastname: Becker
authors.forename: Francis R
authors.initials: FR
authors.lastname: Verdun
authors.forename: Pascal
authors.initials: P
authors.lastname: Gervaz
authors.forename: Pierre-Alexandre
authors.initials: PA
authors.lastname: Poletti
mesh_terms: D015746:Abdominal Pain; D000208:Acute Disease; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D011859:Radiography; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
references.citation: Obstet Gynecol. 1999 Mar;93(3):417-21
references.pmid: 10074991
references.citation: J Am Coll Radiol. 2006 Feb;3(2):115-21
references.pmid: 17412021
references.citation: Clin Radiol. 2007 Jun;62(6):573-8
references.pmid: 17467395
references.citation: Radiology. 1994 Jan;190(1):31-5
references.pmid: 8259423
references.citation: Radiology. 2004 Jul;232(1):164-72
references.pmid: 15155894
references.citation: AJR Am J Roentgenol. 1993 Apr;160(4):763-6
references.pmid: 8456661
references.citation: Eur Radiol. 2005 Dec;15(12):2435-47
references.pmid: 16132914
references.citation: Radiology. 2006 Oct;241(1):83-94
references.pmid: 16928974
references.citation: Radiology. 2005 Aug;236(2):527-34
references.pmid: 16040910
references.citation: AJR Am J Roentgenol. 2005 Jun;184(6):1802-8
references.pmid: 15908534
references.citation: Eur Radiol. 2002 Sep;12(9):2136-50
references.pmid: 12195463
references.citation: AJR Am J Roentgenol. 1998 Oct;171(4):997-1001
references.pmid: 9762983
references.citation: Int J Obes. 1985;9(2):147-53
references.pmid: 4030199
references.citation: Dis Colon Rectum. 2007 Aug;50(8):1223-9
references.pmid: 17566826
references.citation: AJR Am J Roentgenol. 2005 Mar;184(3):855-9
references.pmid: 15728609
references.citation: Radiology. 1999 Nov;213(2):341-6
references.pmid: 10551210
references.citation: Urology. 2006 Jan;67(1):64-8
references.pmid: 16413334
references.citation: Eur Radiol. 2000;10(12):1886-93
references.pmid: 11305565
references.citation: Emerg Radiol. 2006 May;12(4):150-7
references.pmid: 16738930
references.citation: Radiology. 2001 Dec;221(3):747-53
references.pmid: 11719671
references.citation: AJR Am J Roentgenol. 2007 Apr;188(4):927-33
references.pmid: 17377025
references.citation: Radiat Prot Dosimetry. 2008;129(1-3):132-4
references.pmid: 18469347
references.citation: AJR Am J Roentgenol. 1997 Nov;169(5):1275-80
references.pmid: 9353441
references.citation: Radiology. 2000 May;215(2):337-48
references.pmid: 10796905
references.citation: Eur Radiol. 2002 Jun;12(6):1567-70
references.pmid: 12042969
references.citation: Eur Radiol. 2003 Oct;13(10):2278-82
references.pmid: 12845461
references.citation: Am J Surg. 2000 Dec;180(6):450-4; discussion 454-5
references.pmid: 11182396
references.citation: Radiology. 2001 Sep;220(3):683-90
references.pmid: 11526267
references.citation: Clin Imaging. 2005 Jul-Aug;29(4):255-8
references.pmid: 15967316
references.citation: Am J Surg. 1999 Dec;178(6):485-9
references.pmid: 10670858
references.citation: AJR Am J Roentgenol. 2005 Aug;185(2):509-15
references.pmid: 16037529
references.citation: J Comput Assist Tomogr. 2006 Sep-Oct;30(5):758-64
references.pmid: 16954924
references.citation: AJR Am J Roentgenol. 2001 Feb;176(2):497-500
references.pmid: 11159103
references.citation: J Comput Assist Tomogr. 1997 Sep-Oct;21(5):686-92
references.pmid: 9294553
references.citation: Radiology. 1997 Feb;202(2):363-6
references.pmid: 9015058
references.citation: AJR Am J Roentgenol. 2001 Apr;176(4):933-41
references.pmid: 11264081
references.citation: Eur Radiol. 2007 Aug;17(8):2055-61
references.pmid: 17180324
references.citation: Acta Radiol. 2005 Nov;46(7):756-63
references.pmid: 16372698