Imaging Characteristics and Value of Multislice Computed Tomography in the Diagnosis of Acute Appendicitis

Abstract

Objectives: This study was done to describe the imaging characteristics of acute appendicitis on multislice computed tomography (MSCT) and the value of MSCT scan in the diagnosis of acute appendicitis. Methods: The study used retrospective and cross-sectional methods to analyze the results of 117 patients who were taken photos of CT at E Hospital from February 2021 to November 2021. Results: The most common age was over 50 years old, and the average age was 40.1±20.8. The ratio of male/female was 1/1.25. Locations of appendix: right iliac fossa 69.2%, posterior cecum 16.2%, pelvis 12%, subhepatic 0.9%, 1.7% in other places in the abdomen. The diameter of appendicitis was 10.48±2.5mm (the min was 5mm, the max was 18mm). The increase of diameter over 7mm accounted for 95.7%, appendiceal wall thickness ≥ 3mm had 83.8% of patients, and fat infiltration was seen in 88% of cases studied. Other signs: fecal stones 35%, fluid around appendix 7.7%, Douglas fluid 3.4%, right iliac fossa fluid 3.4%, mesenteric lymphadenopathy 25.7%. The rate of appendix rupture diagnosed by CT accounted was 4.3%. The sensitivity, accuracy, and positive diagnostic value of multislice CT in the diagnosis of acute appendicitis were 97.4%, 96.6%, and 99.1%, respectively. Conclusion: Multislice CT has a high value in the diagnosis of acute appendicitis.

Up-to-Date Diagnostic CT Standards for Acute Appendicitis: Wall Thickness and Intraluminal Fluid Thickness

“…Yun et al reported a sensitivity of 96.40% and a specificity of 92.17% for standard-dose CT scans [ 10 ]. Doan et al reported a higher sensitivity (97.4%) and accuracy (96.6%) [ 2 ].…”

“…Appendicitis is one of the most common causes of acute abdomen in adults and has a lifetime risk of 6%-7% [ 1 ]. It is defined as inflammation of the vermiform appendix, an acute condition that presents within 24 hours [ 2 ].…”

“…Multiple imaging modalities, including abdominal computed tomography (CT), ultrasonography, and magnetic resonance imaging (MRI), aid in the clinical diagnosis of appendicitis [ 2 ]. Recently, CT scans with high accuracy have been widely used in acute settings [ 2 ].…”

“…Multiple imaging modalities, including abdominal computed tomography (CT), ultrasonography, and magnetic resonance imaging (MRI), aid in the clinical diagnosis of appendicitis [ 2 ]. Recently, CT scans with high accuracy have been widely used in acute settings [ 2 ]. Moreover, CT scans provide high-resolution images that better evaluate potential complications, eliminate differential diagnoses, and limit unnecessary surgical explorations [ 3 , 4 ].…”