Acute appendicitis: prospective evaluation of a diagnostic algorithm integrating ultrasound and low-dose CT to reduce the need of standard CT
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Pierre-Alexandre Poletti & Alexandra Platon & Thomas De Perrot & Francois Sarasin & Elisabeth Andereggen & Olivier Rutschmann & Elise Dupuis-Lozeron
- چاپ و سال / کشور: 2011
Description
Objectives To evaluate an algorithm integrating ultrasound and low-dose unenhanced CT with oral contrast medium (LDCT) in the assessment of acute appendicitis, to reduce the need of conventional CT. Methods Ultrasound was performed upon admission in 183 consecutive adult patients (111 women, 72 men, mean age 32) with suspicion of acute appendicitis and a BMI between 18.5 and 30 (step 1). No further examination was recommended when ultrasound was positive for appendicitis, negative with low clinical suspicion, or demonstrated an alternative diagnosis. All other patients underwent LDCT (30 mAs) (step 2). Standard intravenously enhanced CT (180 mAs) was performed after indeterminate LDCT (step 3). Results No further imaging was recommended after ultrasound in 84 (46%) patients; LDCTwas obtained in 99 (54%). LDCT was positive or negative for appendicitis in 81 (82%) of these 99 patients, indeterminate in 18 (18%) who underwent standard CT. Eighty-six (47%) of the 183 patients had a surgically proven appendicitis. The sensitivity and specificity of the algorithm were 98.8% and 96.9%. Conclusions The proposed algorithm achieved high sensitivity and specificity for detection of acute appendicitis, while reducing the need for standard CTand thus limiting exposition to radiation and to intravenous contrast media.
Eur Radiol DOI 10.1007/s00330-011-2212-5 Received: 21 March 2011 / Revised: 25 May 2011 / Accepted: 13 June 2011
