You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

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

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

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

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.

Author Information

From the *Department of Radiology, Fujioka General Hospital, Fujioka, Fujiokashi, Gunma, Japan; and †Department of Radiology, Gunma Cancer Tomo Hospital, Takabayashinishi-machi, Otashi, Gunma, Japan.

Received for publication February 11, 2011; accepted July 26, 2011.

Reprints: Takao Moteki, MD, Department of Radiology, Fujioka General Hospital, 942-1, Fujioka, Fujiokashi, Gunma 375-8503, Japan (e-mail:

No funding was received for this work.

The authors have no conflicts of interest.

© 2011 Lippincott Williams & Wilkins, Inc.