Accuracy of Nonenhanced CT vs Contrast-Enhanced CT for Diagnosis of Acute Appendicitis in Adults
| Autor: | Chalerm Eurboonyanun, Julaluck Promsorn, Piyachat Srimunta, Pattra Rungwiriyawanich, Kulyada Eurboonyanun, Nittaya Chamadol |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Enhanced ct Contrast Media Acute abdominal pain Sensitivity and Specificity 030218 nuclear medicine & medical imaging Computed tomographic Iodinated contrast media 03 medical and health sciences 0302 clinical medicine Humans Medicine Radiology Nuclear Medicine and imaging Adverse effect Retrospective Studies business.industry Significant difference Appendicitis Increased risk 030220 oncology & carcinogenesis Acute Disease Acute appendicitis Radiology Tomography X-Ray Computed business |
| Zdroj: | Current Problems in Diagnostic Radiology. 50:315-320 |
| ISSN: | 0363-0188 |
| DOI: | 10.1067/j.cpradiol.2020.01.010 |
| Popis: | Background Acute appendicitis is one of the most common causes of acute abdominal pain requiring emergency intervention. It is often difficult for the clinician to make an accurate diagnosis due to nonspecific and overlapping clinical symptoms. Computed tomography (CT) has become the imaging modality of choice for the evaluation of suspected acute appendicitis. The main purpose of our study was to compare nonenhanced CT (NECT) with contrast-enhanced CT (CECT) for the diagnosis of acute appendicitis. Material and Methods A total of 140 patients were enrolled in the study. Two abdominal radiologists—masked to both the clinical information and the final diagnosis—retrospectively reviewed the computed tomographic findings and made an imaging diagnosis based on (1) NECT only, (2) CECT only, and (3) both NECT and CECT. With the final diagnosis as the reference standard, the accuracy of each CT technique was estimated. Results The respective sensitivity, specificity, and accuracy for NECT, CECT, and NECT + CECT for the diagnosis of acute appendicitis were 80.7%, 86.7%, and 84.3%; 86.0%, 81.9%, and 83.6%; and, 87.7%, 80.7%, and 83.6%. There was no significant difference in the diagnosis of acute appendicitis among the 3 techniques. In order to make a correct diagnosis, the presence of at least 3 imaging findings for NECT or at least 4 for CECT had the best diagnostic accuracy. We also found that 9.25 mm was the optimal cut-off threshold for the detection of patients with acute appendicitis. Conclusion Our study allowed direct comparison between NECT, CECT, and NECT + CECT combined. There was no difference in the ability of each CT technique for diagnosing patients with acute appendicitis. For a patient whom iodinated contrast media is contraindicated or a patient who has an increased risk of severe adverse reaction, we would encourage the use of NECT because it provides comparable diagnostic accuracy without further exposing such patient to the contrast media. |
| Databáze: | OpenAIRE |
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