Diagnostic limitations of 10 mm thickness single-slice computed tomography for patients with suspected appendicitis
Diagnostic limitations of 10 mm thickness single-slice computed tomography for patients with suspected appendicitis
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DOI：
10.1007/s11604-007-0196-5
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发表时间：
2008-02-01
影响因子：
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通讯作者：
Sasai, Keisuke
中科院分区：
文献类型：
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作者：
Kaidu, Motoki;Oyamatu, Manabu;Sasai, Keisuke
目的.本回顾性分析的目的是评估10 mm厚单螺旋CT（CT）检查的准确性，以确认阑尾炎的诊断或提供诊断以外的阑尾炎，包括潜在的阑尾周围肿瘤。2001年4月1日至2005年3月30日，共有272例疑似阑尾炎患者接受了CT检查。在272例患者中，106例（39%）接受了手术。由于CT方案不一致，7例患者的7次CT检查被排除。因此，我们回顾了99张CT图像（99名患者）与手术病理结果的相关性，以阐明CT检查的诊断准确性。我们将术后诊断与术前CT报告进行比较。最终诊断通过手术时的肉眼检查和必要时的病理学评估来证实。在99名患者中，87名在手术时患有急性阑尾炎。CT诊断的敏感性、特异性和准确性分别为98.9%、75.0%和96.0%。阳性预测值为96.6%，阴性预测值为90.0%。在真阴性组的9例患者中，5例患有结肠癌;在假阳性组的3例患者中，2例患有盲肠-阑尾区癌症作为基础疾病。CT检查对怀疑阑尾炎的患者是有用的，但放射科医生应注意厚层单层螺旋CT的局限性。他们还应该意识到其他疾病的可能性，包括同时发生的腹部肿瘤和潜在的盲肠-阑尾癌。
Purpose. The aim of this retrospective analysis was to evaluate the accuracy of 10 mm thickness single helical computed tomography (CT) examination for confirming the diagnosis of appendicitis or providing a diagnosis other than appendicitis, including underlying periappendical neoplasms.Materials and methods. From April 1, 2001 to March 30, 2005, a total of 272 patients with suspected appendicitis underwent CT examinations. Of the 272 patients, 106 (39%) underwent surgery. Seven CT examinations for seven patients were excluded because of inconsistency of the CT protocol. We therefore reviewed 99 CT images (99 patients) with correlation to surgical-pathological findings to clarify the diagnostic accuracy of CT examinations. We compared the postoperative diagnosis with the preoperative CT report. The final diagnoses were confirmed by macroscopic findings at surgery and pathological evaluations if necessary.Results. Of the 99 patients, 87 had acute appendicitis at surgery. The sensitivity, specificity, and accuracy of CT were 98.9%, 75.0%, and 96.0%, respectively. The positive predictive value and negative predictive value were 96.6% and 90.0%, respectively. Among nine patients in the true-negative category, five had colon cancers; and among three patients in the false-positive category, two had cancer of the cecal-appendiceal region as the underlying disease.Conclusion. CT examination is useful for patients with suspected appendicitis, but radiologists should be aware of the limitation of thick-sliced single helical CT. They should also be aware of the possibility of other diseases, including coincident abdominal neoplasms and underlying cecal-appendiceal cancer.