Acute appendicitis: CT and US correlation in 100 patients.

Balthazar, Emil J.; Birnbaum, Bernard A.; Jurng-Jae, Yee; Megibow, Alec J.; Roshkow, Julia E.; Gray, Clinton W.

doi:10.1148/radiology.190.1.8259423

Cited by 354 publications

(180 citation statements)

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“…The inflamed appendix is a noncompressible, tubular structure that shows no peristalsis in the longitudinal view. A transverse diameter of more than 6 mm is a reproducible index suggesting appendicitis (21,22). The reported sensitivity of US in diagnosing acute appendicitis ranges from 75% to 90%, the specificity and accuracy are greater than 90% (20,(22)(23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

“…Some investigators have reported CT to be even more accurate than US (21). Balthazar et al (21) prospectively studied, with CT and US, 100 consecutive patients suspected of having appendicitis. Analysis of the data for CT and US revealed sensitivity of 96% vs. 76%, specificity of 89% vs. 91%, and accuracy of 94% vs. 83%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Bar indicates 10 mm. mation or severe phlegmonous change around the cecal region is easily demonstrated, as is extrapelvic extension of the inflammation (21,27). CT can also easily assess the remainder of the abdomen and pelvis, allowing nonappendiceal diseases with the same symptoms including cholecystitis, pancreatitis, gynecological disease, and urological disease to be diagnosed (21,27).…”

Section: Discussionmentioning

confidence: 99%

“…Widespread availability both geographically and temporally is an important advantage of CT over MRI. A significant disadvantage of CT is radiation exposure, especially since the peak incidence of acute appendicitis is between the late teenage years and early twenties, when pregnancy can be an issue (21,27).…”

Section: Discussionmentioning

confidence: 99%

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MR imaging of the normal appendix and acute appendicitis

Nitta

Takahashi

Furukawa

et al. 2005

Magnetic Resonance Imaging

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Purpose: To describe the MR appearance of the normal appendix and the MR imaging characteristics of acute appendicitis with correlation to pathological severity. Materials and Methods:A total of 20 volunteers participated in this study to demonstrate normal appendices by MR imaging. A total of 37 consecutive patients with clinically diagnosed acute appendicitis were also scanned. T1-weighted (T1WI) spin-echo images, T2-weighted (T2WI) fast spin-echo, and fat-suppressed spectral presaturation inversion recovery T2-weighted (T2SPIR) fast spin-echo images were obtained. The MR criteria for considering acute appendicitis were as follows: 1) thickening of the appendiceal wall with high intensity on T2WI or T2SPIR; 2) dilated lumen filled with high intensity material on T2WI or T2SPIR; and 3) increased intensity of periappendiceal tissue on T2WI or T2SPIR. Results:The visibility of a normal appendix on MR imaging was 90% (18/20). It appeared as a cord-like structure of medium intensity without fluid collection in the lumen. A total of 30 cases with clinically diagnosed acute appendicitis had positive MR findings and all except one were pathologically proven. The one had cecal diverticulitis. These cases demonstrated filled lumen, with a hypointense wall on T1WI and slightly hyperintense on T2WI or T2SPIR. MR findings correlated well with pathological severity, especially a thicker wall, periappendiceal high intensity, and ascites were useful for suspecting severe appendicitis. Conclusion:Correct diagnosis of acute appendicitis was obtained with MRI, and correlated well with its pathological severity. MRI is a powerful alternative for diagnosing acute appendicitis especially for the patients in whom the radiation is major concern. ACUTE APPENDICITIS is one of the most common abdominal diseases and presents as an acute abdomen. The diagnosis is usually based on clinical and laboratory findings, however, approximately one-third of patients with acute appendicitis present with atypical clinical symptoms. This confusion leads to a high prevalence of unnecessary laparotomy, reported at 6% to 16% (1-5). The other cases demonstrate atypical and nonspecific symptoms shared with other abdominal diseases including cholecystitis, gastritis, enterocolitis, diverticulitis, mesenteric adenitis, gynecological disease (e.g., pelvic inflammatory disease [PID], tubo-ovarian abscess, ovarian cyst or torsion, endometriosis, degenerating uterine leiomyoma), and urological disorders (6 -12). In such clinically questionable cases, it is not uncommon that radiological evaluations provide useful information in making a differential diagnosis. An appropriate imaging procedure can prevent surgery delays and minimize the rate of negative laparotomies. Currently, the imaging modalities chosen to demonstrate an inflamed appendix, as well as its complications, are ultrasound (US) and computed tomography (CT). However, MR has not been applied to acute appendicitis.The first objective of this study was to describe the MR appearances of the normal appe...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

MR imaging of the normal appendix and acute appendicitis

Nitta

Takahashi

Furukawa

et al. 2005

Magnetic Resonance Imaging

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“…Scans can be performed without contrast agent [25], with orally and intravenously administered contrast agent [26], with contrast agent applied by oral and colonic routes [27], and with colonically administered contrast medium only [21]. Orally and colonically administered contrast materials yield a high diagnostic accuracy as well as the identification of alternative diagnoses in 80% of cases [27].…”

Section: Right Lower Quadrant Painmentioning

confidence: 99%

Multidetector computed tomography of acute abdomen

et al. 2006

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Acute abdominal pain is one of the most common causes for referrals to the emergency department. The sudden onset of severe abdominal pain characterising the "acute abdomen" requires rapid and accurate identification of a potentially lifethreatening abdominal pathology to provide a timely referral to the appropriate physician. While the physical examination and laboratory investigations are often non-specific, computed tomography (CT) has evolved as the first-line imaging modality in patients with an acute abdomen. Because the new multi-detector CT (MDCT) scanner generations provide increased speed, greater volume coverage and thinner slices, the acceptance of CT for abdominal imaging has increased rapidly. The goal of this article is to discuss the role of MDCT in the diagnostic work-up of acute abdominal pain.

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Computed Tomography and Ultrasonography in the Diagnosis of Appendicitis

et al. 2001

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Hypothesis:Relative merits and indications exist for ultrasonography (US) and computed tomography (CT) in the diagnosis of appendicitis.Design: Prospective study.Setting: General community and tertiary care hospital.Methods: Ninety-nine patients (50 males and 49 females) were studied. Following consent, the initial disposition was recorded, designating the patient for operation, observation, or discharge from the hospital. Each patient was studied by CT and US. Studies were independently evaluated by 2 radiologists, and the results were designated as positive, negative, or equivocal. The surgeon reevaluated patients before and after learning the results of US and CT, recording whether the CT scan, US, or reexamination influenced the final disposition.Results: Fifty patients had appendicitis; 6 appendixes were perforated. The initial clinical impression called for 44 operations, 49 observations, and 6 discharges. Thirtyfour patients had their treatment plan changed from the initial disposition. Ultrasonography did not affect the ini-PAPER

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Acute appendicitis: CT and US correlation in 100 patients.

Abstract: CT is more accurate than US in diagnosis of acute appendicitis.

Cited by 354 publications

References 0 publications

MR imaging of the normal appendix and acute appendicitis

MR imaging of the normal appendix and acute appendicitis

Multidetector computed tomography of acute abdomen

Computed Tomography and Ultrasonography in the Diagnosis of Appendicitis

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