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The value of contrast-enhanced helical CT scan with rectal contrast enema in the diagnosis of acute appendicitis

Show simple item record Naffaa L.N. Ishak G.E. Haddad M.C.
dc.contributor.editor Jul-2005 2017-10-05T15:33:37Z 2017-10-05T15:33:37Z 2005
dc.identifier 10.1016/j.clinimag.2004.11.022
dc.identifier.issn 08997071
dc.description.abstract Background: The aim of this retrospective study is to assess the accuracy of single slice helical CT scan with intravenous, and rectal contrast (CTRC) in the diagnosis of acute appendicitis (AA) in patients with suspected AA, with particular analysis of the diagnostic signs. Participants and methods: Abdomino-pelvic helical CTRC was performed on 75 consecutive patients with suspicion of AA. Radiologic diagnosis was compared with surgical-pathologic results and clinical follow-up. In addition, the CTRC examinations were retrospectively reviewed independently by two experienced radiologists using predefined diagnostic criteria. The sensitivity, specificity, and frequency of each diagnostic sign were calculated. The interobserver agreement and the statistical significance of the frequency for each diagnostic criterion were assessed using the Kappa and Fisher tests, respectively. Results: The accuracy of helical CTRC in the diagnosis of AA was 94.7percent, sensitivity 100percent, specificity 90percent, PPV 89.7percent, and the NPV 100percent. Wall enhancement and nonopacification of the appendix recorded the highest sensitivity and specificity (97percent and 100percent, 94percent and 95percent, respectively). Appendiceal thickness greater than 6 mm was present in 100percent of true-positive cases. However, 26.5percent of true-negative cases had also an appendiceal diameter exceeding 6 mm, a value used as a cut-off for normal appendiceal diameter. The highest interobserver agreement was recorded for appendiceal wall enhancement and for nonopacification of the appendix (K=0.97 and 0.88, respectively). Conclusions: CTRC is an accurate and relatively fast technique for investigation of patients with suspected AA. A negative CTRC can exclude completely the diagnosis of AA. Nonopacification of the appendix and appendiceal wall enhancement are highly sensitive, specific, and reproducible, signs representing major criteria for the diagnosis of AA. © 2005 Elsevier Inc. All rights reserved.
dc.format.extent Pages: (255-258)
dc.language English
dc.publisher NEW YORK
dc.relation.ispartof Publication Name: Clinical Imaging; Publication Year: 2005; Volume: 29; no. 4; Pages: (255-258);
dc.source Scopus
dc.title The value of contrast-enhanced helical CT scan with rectal contrast enema in the diagnosis of acute appendicitis
dc.type Article
dc.contributor.affiliation Naffaa, L.N., Department of Diagnostic Radiology, American University, Beirut Medical Center, PO Box 11-0236, Beirut, Lebanon
dc.contributor.affiliation Ishak, G.E., Department of Diagnostic Radiology, American University, Beirut Medical Center, PO Box 11-0236, Beirut, Lebanon
dc.contributor.affiliation Haddad, M.C., Department of Diagnostic Radiology, American University, Beirut Medical Center, PO Box 11-0236, Beirut, Lebanon
dc.contributor.authorAddress Haddad, M.C.; Department of Diagnostic Radiology, American University, Beirut Medical Center, PO Box 11-0236, Beirut, Lebanon; email:
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Diagnostic Radiology;
dc.contributor.authorDepartment Diagnostic Radiology
dc.contributor.authorFaculty Faculty of Medicine
dc.contributor.authorInitials Naffaa, LN
dc.contributor.authorInitials Ishak, GE
dc.contributor.authorInitials Haddad, MC
dc.contributor.authorReprintAddress Haddad, MC (reprint author), Amer Univ Beirut, Med Ctr, Dept Diagnost Radiol, POB 11-0236, Beirut, Lebanon.
dc.contributor.authorUniversity American University of Beirut Medical Center
dc.description.cited Applegate KE, 2001, AM J ROENTGENOL, V176, P501; BALTHAZAR EJ, 1986, AM J ROENTGENOL, V147, P705; BALTHAZAR EJ, 1991, RADIOLOGY, V180, P21; Garcia Pena Barbara M., 1999, JAMA (Journal of the American Medical Association), V282, P1041; Mittal VK, 2004, ARCH SURG-CHICAGO, V139, P495, DOI 10.1001-archsurg.139.5.495; Raman SS, 2002, AM J ROENTGENOL, V178; Rao PM, 1997, AM J ROENTGENOL, V169, P1275; Walker S, 2000, AM J SURG, V180, P450, DOI 10.1016-S0002-9610(00)00540-7; Wise SW, 2001, AM J ROENTGENOL, V176, P933; Wong SK, 2002, CLIN RADIOL, V57, P741, DOI 10.1053-crad.2001.0950; YACOE ME, 1994, RADIOL CLIN N AM, V32, P899; Zoller W G, 1996, Bildgebung, V63, P78
dc.description.citedCount 9
dc.description.citedTotWOSCount 6
dc.description.citedWOSCount 5
dc.format.extentCount 4
dc.identifier.coden CLIME
dc.identifier.pubmedID 15967316
dc.identifier.scopusID 20444434618
dc.publisher.address 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
dc.relation.ispartOfISOAbbr Clin. Imaging
dc.relation.ispartOfIssue 4
dc.relation.ispartofPubTitle Clinical Imaging
dc.relation.ispartofPubTitleAbbr Clin. Imaging
dc.relation.ispartOfVolume 29
dc.source.ID WOS:000230550800005
dc.type.publication Journal
dc.subject.otherAuthKeyword Appendicitis
dc.subject.otherAuthKeyword CT
dc.subject.otherAuthKeyword Imaging
dc.subject.otherChemCAS Contrast Media
dc.subject.otherChemCAS Iohexol, 66108-95-0
dc.subject.otherChemCAS iopromide, 73334-07-3
dc.subject.otherChemCAS Iothalamic Acid, 2276-90-6
dc.subject.otherChemCAS ioxitalamic acid, 28179-44-4
dc.subject.otherIndex Diagnosis
dc.subject.otherIndex Medical imaging
dc.subject.otherIndex Patient monitoring
dc.subject.otherIndex Radiology
dc.subject.otherIndex Acute appendicitis (AA)
dc.subject.otherIndex CT scan with intravenous and rectal contrast (CTRC)
dc.subject.otherIndex Kappa and Fisher tests
dc.subject.otherIndex Nonopacification
dc.subject.otherIndex Computerized tomography
dc.subject.otherIndex enema
dc.subject.otherIndex acute appendicitis
dc.subject.otherIndex adolescent
dc.subject.otherIndex adult
dc.subject.otherIndex aged
dc.subject.otherIndex article
dc.subject.otherIndex clinical examination
dc.subject.otherIndex contrast enhancement
dc.subject.otherIndex controlled study
dc.subject.otherIndex diagnostic accuracy
dc.subject.otherIndex diagnostic value
dc.subject.otherIndex female
dc.subject.otherIndex Fisher exact test
dc.subject.otherIndex follow up
dc.subject.otherIndex human
dc.subject.otherIndex major clinical study
dc.subject.otherIndex male
dc.subject.otherIndex priority journal
dc.subject.otherIndex radiodiagnosis
dc.subject.otherIndex school child
dc.subject.otherIndex sensitivity and specificity
dc.subject.otherIndex spiral computer assisted tomography
dc.subject.otherIndex statistical significance
dc.subject.otherIndex Acute Disease
dc.subject.otherIndex Adolescent
dc.subject.otherIndex Adult
dc.subject.otherIndex Aged
dc.subject.otherIndex Aged, 80 and over
dc.subject.otherIndex Appendicitis
dc.subject.otherIndex Child
dc.subject.otherIndex Contrast Media
dc.subject.otherIndex Enema
dc.subject.otherIndex Female
dc.subject.otherIndex Humans
dc.subject.otherIndex Iohexol
dc.subject.otherIndex Iothalamic Acid
dc.subject.otherIndex Male
dc.subject.otherIndex Middle Aged
dc.subject.otherIndex Predictive Value of Tests
dc.subject.otherIndex Retrospective Studies
dc.subject.otherIndex Sensitivity and Specificity
dc.subject.otherIndex Tomography, Spiral Computed
dc.subject.otherKeywordPlus SUSPECTED APPENDICITIS
dc.subject.otherWOS Radiology, Nuclear Medicine and Medical Imaging

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