title: Evaluation of the maximum depth of intraluminal appendiceal fluid to diagnose appendicitis with a 64-detector row CT scanner.
abstract: OBJECTIVE
  The objective of this study was to investigate whether the criterion "maximum depth of intraluminal appendiceal fluid greater than 2.6 mm" ("DEPTH >2.6 mm"), with the use of 64-detector row computed tomography, is useful to diagnose appendicitis.
  
  
  METHODS
  We retrospectively evaluated 0.68-mm-thick images of 2894 intravenously enhanced abdominal-pelvic computed tomography using the following criteria: (1) appendiceal wall thickness greater than 3 mm, (2) appendiceal wall enhancement, (3) focal cecal wall thickening, (4) adjacent lymphadenopathy greater than 5 mm, (5) appendicolith, (6) periappendiceal inflammation, and (7) the new criterion, DEPTH >2.6 mm. Of the 2894 images, 1013 were classified into normal group (including 622 distended [diameter >6 mm] but normal appendices without adjacent lesions), modified group (235 distended normal appendices modified with adjacent lesions), proven-appendicitis group (82 operatively proven appendicitis cases), and clinical-appendicitis group (62 clinically certified appendicitis cases).
  
  
  RESULTS
  The new criterion, DEPTH >2.6 mm, demonstrated both higher sensitivities and higher specificities in all groups (>90%), although this criterion showed lower specificities than some conventional criteria. In contrast, conventional criteria showed lower sensitivities or lower specificities (<60%) in one or more of these groups.
  
  
  CONCLUSIONS
  DEPTH >2.6 mm is particularly useful for differentiating appendicitis from distended normal appendix.
authors.affiliation: Department of Radiology, Fujioka General Hospital, Fujioka, Fujiokashi, Gunma, Japan. pwd8ja227h@md.point.ne.jp
authors.forename: Takao
authors.initials: T
authors.lastname: Moteki
authors.forename: Nariyuki
authors.initials: N
authors.lastname: Ohya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Horikoshi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000000981:diagnostic imaging*; D001826:Body Fluids / Q000000981:diagnostic imaging*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D006801:Humans; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007479:Iopamidol