Acute pelvic inflammatory disease: diagnostic performance of CT.
OBJECTIVE
To evaluate retrospectively the performance of computed tomography (CT) for the diagnosis of acute pelvic inflammatory disease (PID) by the use of clinical and laboratory data as the reference standard.


METHODS
The study was approved by the institutional review board. A total of 190 women of reproductive age (age range, 16-49 years; mean age, 29.3 ± 7.6 years) with complaints of non-traumatic acute lower abdominal pain underwent subsequent abdominopelvic CT. The diagnosis of acute PID was confirmed by the clinical and laboratory findings. Two radiologists performed a blinded, independent, retrospective review of the CT findings of acute PID. Discordant findings were resolved by a consensus review with a third radiologist. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of each CT finding for the diagnosis of acute PID were determined. Kappa statistics were used to estimate agreement between readers.


RESULTS
Pelvic inflammatory disease was present in 48 (25.3%) of the 190 patients. The most specific CT finding for the diagnosis of acute PID was tubal thickening of both fallopian tubes (95.1%). The most sensitive CT finding was mid-pelvic fat stranding (60.4%).


CONCLUSIONS
The CT finding of tubal thickening is highly specific for the diagnosis of acute PID, although overall CT sensitivity is poor.
Department of Radiology, Konkuk University Medical Center, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea.
Sung Il
SI
Jung
Young Jun
YJ
Kim
Hee Sun
HS
Park
Hae Jeong
HJ
Jeon
Kyung-Ah
KA
Jeong
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D005187:Fallopian Tubes / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D015588:Observer Variation; D000292:Pelvic Inflammatory Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed