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Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e3182324443
Original Article

Evaluation of the Maximum Depth of Intraluminal Appendiceal Fluid to Diagnose Appendicitis With a 64–Detector Row CT Scanner

Moteki, Takao MD*; Ohya, Nariyuki MD; Horikoshi, Hiroyuki MD

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Objective: The objective of this study was to investigate whether the criterion “maximum depth of intraluminal appendiceal fluid greater than 2.6 mm” (“DEPTH >2.6 mm”), with the use of 64–detector row computed tomography, is useful to diagnose appendicitis.

Methods: We retrospectively evaluated 0.68-mm-thick images of 2894 intravenously enhanced abdominal-pelvic computed tomography using the following criteria: (1) appendiceal wall thickness greater than 3 mm, (2) appendiceal wall enhancement, (3) focal cecal wall thickening, (4) adjacent lymphadenopathy greater than 5 mm, (5) appendicolith, (6) periappendiceal inflammation, and (7) the new criterion, DEPTH >2.6 mm. Of the 2894 images, 1013 were classified into normal group (including 622 distended [diameter >6 mm] but normal appendices without adjacent lesions), modified group (235 distended normal appendices modified with adjacent lesions), proven-appendicitis group (82 operatively proven appendicitis cases), and clinical-appendicitis group (62 clinically certified appendicitis cases).

Results: The new criterion, DEPTH >2.6 mm, demonstrated both higher sensitivities and higher specificities in all groups (>90%), although this criterion showed lower specificities than some conventional criteria. In contrast, conventional criteria showed lower sensitivities or lower specificities (<60%) in one or more of these groups.

Conclusions: DEPTH >2.6 mm is particularly useful for differentiating appendicitis from distended normal appendix.

© 2011 Lippincott Williams & Wilkins, Inc.



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