Diagnostic power of various computed tomography signs in diagnosing acute appendicitis

Lai, Vincent S.; Chan, Wan Chi; Lau, Hin Yue; Yeung, Tsz Wai; Wong, Yiu Chung; Yuen, Ming Keung

doi:10.1016/j.clinimag.2011.04.003

Cited by 31 publications

(20 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The MOD is sufficient for diagnosing appendicitis regardless of the other CT criteria when the appendix is >10 mm or <6 mm, and the cutoff value of the MOD comes out as not 6 mm but 8.2 mm, which is similar to previous reports (25,26). According to our ROC curve analysis, the diagnostic performance of the MOD declines for appendices of borderline diameter, whereas the criterion of the DWC provides a consistent diagnostic performance Figure 3.…”

Section: Discussionsupporting

confidence: 68%

“…There have been a few reports suggesting that CT criteria should be adapted to take into account normal appendiceal distension and proposing a cutoff value of between 8 and 9 mm (25,26). The difference between that new value and the conventional cutoff is about 2-2.5 mm, which implies that the normal appendix can be distended on average 2-2.5 mm from its collapsed state.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

How to Evaluate Appendices with Borderline Diameters on CT

Kim

Ryu

et al. 2014

Academic Radiology

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 98%

How to Evaluate Appendices with Borderline Diameters on CT

Kim

Ryu

et al. 2014

Academic Radiology

View full text Add to dashboard Cite

“…In postmenopausal women and older men MDCT (with or without contrast administration) is recommendable. However, in case of suspected perforation considering CRP levels more than 121.5 mg/L MDCT with administration of intravenous contrast material is essential to detect signs of AA e.g., ring-like contrast-enhancement of the thickened appendiceal wall and abscess formation in the RLQ [12,13].…”

Section: Discussionmentioning

confidence: 99%

“…MDCT images were visually evaluated for the presence of various appendicitis signs [12][13][14][15][16]: (Figures 2a and 2b). 5.…”

Section: Image Analysismentioning

confidence: 99%

See 1 more Smart Citation

Computed tomography in adults with atypical clinical presentation of acute appendicitis: comparison of findings with inflammatory serum markers

Karul¹,

Avanesov²,

Schoennagel³

et al. 2013

Gasteroentrol Intest Syst

View full text Add to dashboard Cite

Purpose: To evaluate both the potential usefulness of multidetector computed tomography (MDCT) in diagnosis of acute appendicitis (AA) in patients with atypical clinical presentation and to compare findings with C-reactive protein (CRP) and white cell count (WCC). Materials and methods: MDCT images in 69 patients with atypical presentation of AA were retrospectively reviewed by two readers in consensus. Diagnostic accuracy, sensitivity, specificity, positive and negative predictive values (PPV/NPV) were assessed considering histopathological evaluation as reference. Patients with AA were grouped in nonperforated vs perforated and CRP/ WCC were correlated using both Chi-square-test (χ 2 ) and receiver operating characteristic (ROC) curve analysis. Results: 39 patients underwent surgery and AA was confirmed histopathologically in 29/39 cases (74.4%), showing nonperforated AA (n=23, 79.3%) and perforated AA (n=6, 20.7%). In the remaining 10/39 patients (25.6%) diverticulitis of sigmoid colon was diagnosed (n=3); colitis (n=4); cholecystitis (n=3). Among the other 30/69 patients MDCT was either unremarkable (n=18) or differentials were detected (n=12). Diagnostic accuracy in patients with histopathologically confirmed AA was 95.7%, sensitivity was 90.6%, specificity was 93.6%, PPV was 83.0%, and NPV was 89.8%. All MDCT findings but calcified appendicoliths and CRP/WCC correlated statistical significant when AA was confirmed histopathologically (χ 2 =26.2; p<0.001). In contrary to WCC (p=0.11), CRP was significantly higher in patients with perforated AA than nonperforated AA (p<0.01), demonstrating an optimal cut-off value >121.5 mg/L. Conclusion: MDCT is required immediately to rule out perforation in patients with suspected AA despite atypical clinical presentation and a CRP level >121.5 mg/L.

show abstract

Variations and morphometric features of the vermiform appendix: A systematic review and meta‐analysis of 114,080 subjects with clinical implications

et al. 2019

View full text Add to dashboard Cite

Determining the true and indisputable data regarding the vermiform appendix (VA) morphology is of a great clinical interest. The aim of this study was to provide the best evidence‐based anatomical overview of the variations in location and size of VA using a systematic and meta‐analytical approach. A systematic review with meta‐analysis was performed of studies reporting variants of the location and morphometric data regarding the VA. The MEDLINE/PubMed, ScienceDirect, EMBASE, BIOSIS, SciELO, and Web of Science databases were thoroughly searched throughout June 2018. The reported locations of the body of the VA were re‐classified into a new, standardized classification system divided into nine categories. The AQUA tool was used to assess the quality of included studies. The research was conducted following PRISMA guidelines and registered at PROPSERO database. Our meta‐analysis included 242 studies (n = 114,080). Overall, the VA was most commonly found in the retrocecal location (32.1%, 95%CI: 29.2–35.1), followed by the pelvic (28.5%, 95%CI: 26.7–30.4) and ileal (14.5%, 95%CI: 11.8–17.7) locations. Subjects without known appendiceal pathologies had significantly smaller VA outer diameters (5.84 mm, 95%CI: 5.68–5.99) than patients diagnosed with acute appendicitis (10.64 mm, 95%CI: 10.14–11.15). The overall pooled mean length of the VA was 80.29 mm (95%CI: 76.68–83.89). Significant differences were found in size of the VA between imaging modalities. The results obtained from this evidence‐based anatomy study will improve the clinical understanding of the VA anatomy, which in turn will have major implications for clinical practice. Clin. Anat. 32:85–98, 2019. © 2019 Wiley Periodicals, Inc.

show abstract

Diagnostic power of various computed tomography signs in diagnosing acute appendicitis

Cited by 31 publications

References 37 publications

How to Evaluate Appendices with Borderline Diameters on CT

How to Evaluate Appendices with Borderline Diameters on CT

Computed tomography in adults with atypical clinical presentation of acute appendicitis: comparison of findings with inflammatory serum markers

Variations and morphometric features of the vermiform appendix: A systematic review and meta‐analysis of 114,080 subjects with clinical implications

Contact Info

Product

Resources

About