title: Optimised z-axis coverage at multidetector-row CT in adults suspected of acute appendicitis.
abstract: OBJECTIVE
  To compare diagnostic performances of two reduced z-axis coverages to full coverage of the abdomen and pelvis for the diagnosis of acute appendicitis and alternative diseases at unenhanced CT.
  
  
  METHODS
  This study included 152 adults suspected of appendicitis who were enrolled in two ethical committee-approved previous prospective trials. Based on scans covering the entire abdomen and pelvis (set L), two additional sets of images were generated, each with reduced z-axis coverages: (1) from the top of the iliac crests to the pubis (set S) and (2) from the diaphragmatic crus to the pubis (set M). Two readers independently coded the visualisation of the appendix, measured its diameter and proposed a diagnosis (appendicitis or alternative). Final diagnosis was based on surgical findings or clinical follow-up. Fisher exact and McNemar tests and logistic regression were used.
  
  
  RESULTS
  46 patients had a definite diagnosis of appendicitis and 53 of alternative diseases. The frequency of appendix visualisation was lower for set S than set L for both readers (89% and 84% vs 95% and 91% by Readers A and B, respectively; p=0.021 and 0.022). The probability of giving a correct diagnosis was lower for set S (68%) than set L (78%; odds ratio, 0.611; p=0.008) for both readers, without significant difference between sets L and M (77%, p=0.771); z-axis coverage being reduced by 25% for set M.
  
  
  CONCLUSIONS
  Coverage from diaphragmatic crus to pubis, but not focused on pelvis only, can be recommended in adults suspected of appendicitis.
  
  
  CONCLUSIONS
  In suspected appendicitis, CT-coverage can be reduced from diaphragmatic crus to pubis.
authors.affiliation: Department of Radiology, Hôpital Erasme, Université libre de Bruxelles, Brussels, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Brassart
authors.forename: C
authors.initials: C
authors.lastname: Winant
authors.forename: D
authors.initials: D
authors.lastname: Tack
authors.forename: P A
authors.initials: PA
authors.lastname: Gevenois
authors.forename: V
authors.initials: V
authors.lastname: De Maertelaer
authors.forename: C
authors.initials: C
authors.lastname: Keyzer
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010388:Pelvis / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011860:Radiography, Abdominal; D055815:Young Adult