scholarly journals ROLE OF CT SCAN IN DIAGNOSIS OF ACUTE APPENDICITIS

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Saurabh . ◽  
Deepak Meena ◽  
G. L. Meena
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Predictive Value ◽  
Contrast Material ◽  
Spiral Ct ◽  
Daily Routine ◽  
Suspected Acute Appendicitis

Background: To evaluate the diagnostic accuracy of the spiral-CT in patients with clinically suspected acute appendicitis. Methods: Appendiceal spiral-CT was performed in 50 patients (21 women and 29 men) with clinically suspected acute appendicitis. Scans were obtained from the L4 level to the symphysis pubis using 5 mm collimation without i.v., oral, or rectal contrast material. Prospective diagnoses based on CT findings were compared with histopathological results Results: In our study appendix diameter test sensitivity was 97.56%, specificity was 77.78 %, positive predictive value was 95.27%, negative predictive value was 87.50% and diagnostic accuracy was 94.00%. Conclusion: The accuracy of computed tomography in diagnosing acute appendicitis was high. The results emphasize the role of computed tomography as an accurate modality in daily routine diagnostics for acute appendicitis in all clinical emergency settings. Key words: Appendicitis, CT scan, Accuracy.

Diagnostic Performance and Reliability of the Standardized Computed Tomography Reporting System for Acute Appendicitis: Experience in a Tertiary Care Academic Center

2021 ◽  
Vol 104 (7) ◽  
pp. 1102-1108
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Interobserver Agreement ◽  
Reporting System ◽  
Lower Quadrant ◽  
Suspected Appendicitis ◽  
Diagnostic Certainty

Background: Computed tomography (CT) is generally accepted as a modality of choice for imaging workup in patients with suspected appendicitis. A standardized CT reporting system, CT certainty score, has been proposed to improve diagnostic accuracy and to reduce ambiguous CT reports. Objective: To assess the diagnostic performance and the reliability of the standardized CT reporting system for acute appendicitis in Thai adults. Materials and Methods: The present study was a retrospective data review of 421 adult patients who had CT scans of the appendix between January 2016 and December 2017. The clinical and imaging data were extracted and analyzed. The pathological result was used as a standard of reference. The diagnostic performance and interobserver agreement of the standardized CT reporting system were estimated. Results: One hundred sixty-three patients, with a mean age of 41.7 years, had clinical diagnoses of acute appendicitis. Using standardized CT report, radiologists were highly accurate at diagnosing appendicitis [area under curve (AUC) 0.988 (95% CI 0.98 to 1.00); p<0.001]. The estimated sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.1% (95% CI 90.6 to 97.9), 95.7% (95% CI 92.5 to 97.9), 93.4% (95% CI 88.7 to 96.2), 96.9% (95% CI 93.0 to 97.2), 95.5% (95% CI 93.0 to 97.3), respectively. The interobserver agreement was greater than 80% for all binary objective findings and more than 90% agreement on the presence or absence of greater-than-3-mm wall thickness, appendicolith, periappendiceal air, and right lower quadrant fluid collection. The use of CT certainty score had interobserver agreement of 78% (κ=0.69; 95% CI 0.62 to 0.77). Conclusion: Using a standardized CT reporting system yielded a high diagnostic accuracy and high reproducibility of supportive CT findings for appendicitis in at-risk patients. The standardized CT reporting system can improve diagnostic certainty, accuracy, and guide patient management. Keywords: Appendicitis; Certainty score; Computed tomography; Standardized reporting system

scholarly journals ROLE OF COMPUTED TOMOGRAPHY IN SUSPECTED ACUTE APPENDICITIS : A STUDY

2014 ◽  
Vol 3 (17) ◽  
pp. 4643-4647
Author(s):  
Yassir M Abdulla ◽  
Reshmina C C Dsouza ◽  
Sandeep M B ◽  
Omprakash A. R ◽  
Tessa J ose Kaneria ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Suspected Acute Appendicitis

scholarly journals A three year prospective study-suspected acute appendicitis: diagnostic accuracy of modified Alvarado score versus ultrasonography in adults

2017 ◽  
Vol 4 (12) ◽  
pp. 3924
Author(s):  
Murhari D. Gaikwad ◽  
Anand Auti ◽  
Avinash Magare
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Prospective Study ◽  
Predictive Value ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Alvarado Score ◽  
Suspected Appendicitis ◽  
Modified Alvarado Score ◽  
Suspected Acute Appendicitis

Background: To evaluate and compare diagnostic accuracy of modified Alvarado score and ultrasonography in co-relation to histopathology report for diagnosis of acute appendicitis.Methods: A prospective study of the patients who underwent appendectomy for suspected acute appendicitis at IIMS and R Medical College and Noor Hospital Warudi, Badnapur, Dist. Jalna (Maharashtra). The clinical (radiological) and ultrasonography data of 760 patients with suspected appendicitis was collected between March 2014 to Feb. 2017. These patients were evaluated by modified Alvarado score and ultrasonographically, which was corrected with histopathological finding.Results: Out of 760 patients 69.34% had acute appendicitis 63.81% had modified Alvarado score≥7 and 58.28% patients were ultrasonographically positive. In present study modified Alvarado score has sensitivity of 89.37% specificity 93.99% positive predictive value 97.11%, negative predictive value 79.64%, diagnostic accuracy of 81.32%.Conclusions: Modified Alvarado score can be used effectively in clinical decision making. When compare with ultrasonography neither one is advantageous. However, additional information provided by ultrasonography improves diagnostic accuracy.

scholarly journals Echoskopijos ir kompiuterinės tomografijos reikšmė diagnozuojant ūminį apendicitą

2003 ◽  
Vol 1 (3) ◽  
pp. 0-0
Author(s):  
Raminta Šydeikienė ◽  
Jūratė Dementavičienė ◽  
Aurelijus Grigaliūnas
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Acute Appendicitis ◽  
Correct Diagnosis ◽  
Contrast Material ◽  
Clinical Findings ◽  
Lower Quadrant ◽  
Additional Information ◽  
Emergent Surgery ◽  
Suspected Acute Appendicitis

Raminta Šydeikienė1, Jūratė Dementavičienė2, Aurelijus Grigaliūnas11 Vilniaus greitosios pagalbos universitetinė ligoninė,Šiltnamių g. 29, LT-2043 Vilnius,2 Vilniaus universiteto ligoninė "Santariškių klinikos",Santariškių g. 2, LT-2021 VilniusEl paštas: [email protected] Įvadas / tikslas Ūminio apendicito diagnozę dažniausiai galima tiksliai nustatyti pagal klinikinius požymius ir sėkmingai taikyti chirurginį gydymą. Tačiau apie 20–30% operacinių radinių nepatvirtina ūminio apendicito diagnozės – kirmėlinė atauga būna nepakitusi. Todėl neaiškiais klinikiniais atvejais turėtų būti taikomas nuodugnesnis ligonio ištyrimas prieš operaciją, kad galėtume nustatyti skausmo dešiniajame apatiniame pilvo kvadrante priežastį. Mūsų tyrimo tikslas – nustatyti ultragarso (UG) ir kompiuterinės tomografijos (KT) reikšmę diagnozuojant ūminį apendicitą. Ligoniai ir metodai Kiekvienais metais Vilniaus greitosios pagalbos universitetinės ligoninės Bendrosios chirurgijos centre operuojama apie 750 ligonių, kuriems diagnozuojamas ūminis apendicitas. Nuo 2000 m. iki 2003 m. pirmojo pusmečio pabaigos 225 ligoniams, tirtiems ultragarsu, buvo nustatyta ūminio apendicito diagnozė. Mūsų ligoninėje operuoti 193 ligoniai (85,78%), iš jų 101 moteris ir 92 vyrai (amžius nuo 16 iki 80 metų). Rezultatai Iš 225 ligonių, kuriems ultragarsu buvo nustatyta ūminio apendicito diagnozė, mūsų ligoninėje operuoti 193 (85,78%). 32 ligoniams (14,22%) chirurginis gydymas nebuvo taikytas. Operacijos radiniai su UG nesutapo 44 atvejais (22,8%), iš kurių 20 atvejų (10,4%) buvo diagnozuotas katarinis apendicitas, 24 atvejais (12,4%) – kita patologija: divertikulitas, Krono liga, pūlinis adneksitas, aklosios ir storosios žarnų navikai ir kt. 149 ligoniams (77,20%) nustatyta ūminio apendicito diagnozė, iš jų 82 (42,49%) – flegmoninis apendicitas, 25 (12,95%) – gangreninis apendicitas, 42 (21,76%) – gangreninis perforacinis apendicitas ir apendikulinis abscesas. Kompiuterinė tomografija buvo atlikta 43 ligoniams, kuriems ūminio apendicito klinika, subjektyvūs skundai, objektyvių tyrimų duomenys ir ligos eiga buvo ne visai tipiški, o UG tyrimu diagnozė nenustatyta. Šešiolikai ligonių buvo patvirtinta ūminio ar ūminio komplikuoto apendicito diagnozė, 10 ligonių pokyčių nerasta, o 17 ligonių diagnozuotos kitos ligos. Išvados Pilvo dešiniojo apatinio kvadranto skausmą gali sukelti daugelis ūminių ligų. Kai klinikiniai radiniai yra abejotini, turėtų būti atliekamas ultragarsinis tyrimas. Tais atvejais, kai diagnozė lieka neaiški, būtina atlikti pilvo ir dubens kompiuterinę tomografiją. Prasminiai žodžiai: ūminis apendicitas, ultragarsinis tyrimas (UG), sonoskopija, kompiuterinė tomografija (KT). The value of ultrasonography and computed tomography in diagnosing acute appendicitis Raminta Šydeikienė1, Jūratė Dementavičienė2, Aurelijus Grigaliūnas1 Background / objective The purpose of our study was to determine the role of US and CT in differential diagnosis of suspected acute appendicitis. In most cases the clinical findings are reliable for correct diagnosis and emergent surgery due to acute appendictitis. Nevertheless, 20–30% of operation findings do not confirm the diagnosis of acute appendicitis (normal appendix is found). In some cases additional examinations should be done prior to surgery. Patients and methods Every year almost 750 patients with acute appendicitis are operated on at Vilnius University Emergency Hospital. 225 patiens were examined with US for suspected acute appendicitis in the period 2000–half 2003. In 193 cases (85.78%) patients were operated on. Sex: 101 F, 92 M. The age varied from 16 to 80 years. By CT, 43 patients were examined. In all cases helical unenhanced CT was performed, with collimation 8 mm and table feed 12 mm. In the cases when differential diagnosis was necessary, 50 ml of 300 g/ml J nonionic contrast material was injected i/v (by hand). Results For suspected acute appendicitis 225 patients were examined with US. In 193 cases (85.78%) patients were operated on. In 32 cases (14.22%) no emergent surgery was performed in our hospital. The disagreement of findings was in 44 cases (22.8%), where in 20 cases (10.4%) appendicitis catarrhalis and in 24 cases (12.4%) other pathology (coecum, colon tumor, Crohn’s disease, diverticulitis, adnexitis) were found. In 149 cases (77.20%) the diagnosis of acute appendicitis was confirmed, including phlegmonous in 82 cases (42.49%), gangrenous in 25 cases (12.95%), gangrenous perforated and appendiculas abscesses in 42 cases (21.76%). CT revealed acute or acute complicated appendicitis in 16 cases, no changes were found in 10 cases, other diseases were found in 17 cases. Conclusions Acute clinical presentation of the diseases in the right lower quadrant could be caused by a broad spectrum of pathologies.When clinical findings are doubtful, US should be performed. In the case when all data do not confirm the diagnosis, CT is necessary for additional information and correct diagnosis. Keywords: acute appendicitis, ultrasound (US), computed tomography (CT).

scholarly journals Accuracy of Alvarado Scoring System and Selective Computed Tomography in Diagnosis of Suspected Cases of Acute Appendicitis

2020 ◽  
Vol 1 (2) ◽  
pp. 01-11
Author(s):  
Abbas AR Mohamed ◽  
Safaa A Mobarki ◽  
Ashwag H Al Qabasani ◽  
Nusiba A Al Shingiti ◽  
Alaa A El Sayed
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Scoring System ◽  
Oral Contrast ◽  
Middle Group ◽  
Group A ◽  
Group B

Objective: To evaluate the diagnostic accuracy of combined Alvarado scoring system and selective computed tomography (CT) in the diagnosis of suspected cases of acute appendicitis. Material and methods: This study was conducted during the period March 2018 to January 2020 at Prince Mohammed bin Abdul-Aziz hospital (NGHA) in Al Madinah, KSA. It is a prospective study involving 100 consecutive patients attending the emergency department with right iliac fossa pain, excluding children below the age of 14 years and pregnant women. All patients were initially assessed by the Alvarado scoring system, and the result of each patient was recorded in a separate predesigned data sheath. Based on the patient's calculated Alvarado scores, patients were stratified into three groups: Group A (score ≤ 4), Group B (score 5-6), and group C (score ≥ 7). All patients in group A were discharged from the emergency department with instruction to return if their symptoms persist or get worse while all patients in group B had an abdominal multidetector CT scan (MDCT) with IV contrast and no oral contrast to help the diagnosis. Group C patients had surgery without further investigation. Alvarado scores were compared to intraoperative findings and histopathological examination of the removed appendix in those who were operated. The sensitivity, specificity, positive and negative predictive values of the scoring system in each group were calculated with special reference to the role of CT scan in improving the diagnostic accuracy of the scoring system in the middle group (group B). Result: 58 patients were male and 42 were female. Age range between 14 and 43 years with median age 24 years. Out of the 100 patients, 14 (8 males, 6 females) belonged to Group A, 23 (11 males, 12 females) to Group B and 63 (39 males, 24 females) to group C. Two patients from group A (one male and one female) were returned with worsening symptoms and subsequently operated for acute appendicitis. CT scan established the diagnosis of acute appendicitis in 16 out of the patients of group B with subsequent histological confirmation of acute appendicitis in 15 of them. Histopathology confirmed the diagnosis of acute appendicitis in 32 out of 63 patients of group C. Conclusion: Alvarado score has a high accuracy of ruling in and out acute appendicitis at the extremes of the score (≤7 and ≥4), however, the accuracy of the score to confirm or rule out acute appendicitis in the middle group (5 -6) is significantly low. Selective utilization of CT scan in patients in the middle of the score improves the diagnostic accuracy of the score and limits overutilization of CT scan in the other patients at the extremes of the score saving patients unnecessary exposure to radiation and health authorities’ time and cost without increasing the rate of negative appendectomy.

The added value of SPECT/spiral CT in patients with equivocal bony metastasis from hepatocellular carcinoma

2015 ◽  
Vol 54 (06) ◽  
pp. 255-261 ◽  
Author(s):  
H. Shi ◽  
B. Li ◽  
L. Cai ◽  
Y. Gu ◽  
Y. Xiu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Hepatocellular Carcinoma ◽  
Bone Metastasis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Spiral Ct ◽  
Whole Body ◽  
Bone Lesions ◽  
Kappa Value ◽  
Sensitivity Specificity

SummaryThe aim of this study was to evaluate the incremental value provided by single-photon emission computed tomography (SPECT)/spiral computed tomography (CT) over SPECT alone for the evaluation of equivocal bone lesions in patients with hepatocellular carcinoma (HCC). Patients, methods: This was a retrospective study of 65 patients (61 men and 4 women; mean age, 53.1 ± 10.1 years; age range, 31–78 years) with HCC confirmed by pathology who underwent planar whole body scintigraphy and SPECT/CT. Each lesion was scored visually using a 5-point scale (0, negative; 1, benign; 2, likely benign; 3, likely bone metastasis; 4, bone metastasis). Lesions in which diagnostic confidence was scored as 3 or 4 were categorized into metastases.The final diagnosis of each lesion was based on pathological confirmation or follow-up by whole body scintigraphy and SPECT/spiral CT conducted two or more times. The diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of SPECT alone and SPECT/CT were computed. Results: The diagnostic accuracy, sensitivity, specificity, PPV, and NPV of SPECT alone were 78.4, 70.9%, 94.9%, 96.8% and 59.7%, respectively. Moreover, for agreement of SPECT alone and the final results, the kappa value was 0.567 (p < 0.001), which was considered to be moderate agreement. The diagnostic accuracy, sensitivity, specificity, PPV, and NPV of SPECT/CT were 99.2%, 100%, 97.4%, 98.9% and 100 %, respectively. Furthermore, for agreement of SPECT/CT and the final results, the kappa value was 0.981 (p < 0.001), which was considered to be nearly perfect agreement. Conclusions: SPECT/spiral CT is more accurate and valuable than SPECT alone in the differential diagnosis of equivocal bone lesions in patients with HCC.

scholarly journals Accuracy of Ultrasound Scanning in Diagnosing Acute Appendicitis in Patients Admitted at Vicente Sotto Memorial Medical Center

2020 ◽  
Vol 3 (2) ◽  
pp. 134-139
Author(s):  
Uma Gurung ◽  
Dhiraj Gurung
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Medical Center ◽  
Diagnostic Tools ◽  
Advantages And Disadvantages ◽  
Sensitivity Specificity ◽  
Suspected Acute Appendicitis

Introduction: Acute appendicitis is the most common abdominal surgical emergency. Both abdominal ultrasonography and computed tomography are common diagnostic tools in its diagnosis with each having its own advantages and disadvantages. Methods: Patients of suspected acute appendicitis were evaluated with an ultrasound to see the sensitivity, specificity, positive and negative predictive value of ultrasound for intraoperative appendicitis diagnosis. The study included 113 patients of suspected acute appendicitis presenting in the emergency during a one year duration. Sensitivity, specificity, positive predictive value and negative predictive value was calculated from their respective formulae. Results: The majority of the patients were male patients between the age group of 18 to 30. The sensitivity of ultrasound for diagnosis of acute appendicitis was 96% and specificity was 33%. The positive predictive value was 98% and the negative predictive value was 20% Conclusion: Ultrasound has good sensitivity and the low cost along with no radiation exposure makes this an acceptable screening investigative modality though due to low specificity, it would be recommended to go for a computed tomography scan if ultrasound shows negative result for appendicitis.  

scholarly journals Role of Computed Tomography Scan in The Evaluation of Cerebral Palsy in Children

KYAMC Journal ◽  
2020 ◽  
Vol 11 (1) ◽  
pp. 3-8
Author(s):  
Momotaj Begum ◽  
Sabina Yiasmeen ◽  
Mahmud Hossain ◽  
Shafi Ahmed ◽  
Salahuddin Al Azad ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cerebral Palsy ◽  
Ct Scan ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Computed Tomography Scan ◽  
Cross Sectional ◽  
Tomography Scan

Background. Cerebral palsy is one of the common childhood neurological problem which occurs due to defect or lesion in immature brain. The worldwide incidence of cerebral palsy is approximately 2-2.5 per 1000 live births. There have been many works on the role of computed tomography scan in the diagnosis of cerebral palsy. Objective: The objective information available from careful review of imaging information such as CT brain scans, is an important adjunct to clinical data. Materials and Methods: This cross sectional study was carried out in the department of Radiology and Imaging, BSMMU and department of Paediatric Neurology unit over a period of 12 months from January 2019 to December 2019. We calculated the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT scan in diagnosis of CP in children. Results: This cross sectional study was carried out on consecutively selected 94 children below 15 years having clinical evidence of cerebral palsy. Among the study subjects 86.2% were diagnosed as cerebral palsy through CT scan. Conclusion: The sensitivity and specificity of CT scan of present study was found to be quite high in children which suggests a CT scan as an effective investigation for the diagnosis of cerebral palsy. KYAMC Journal Vol. 11, No.-1, April 2020, Page 3-8

scholarly journals Assessment of Imaging Performance and Accuracy for the Diagnostic Evaluation of Wilms Tumor in Kids in the ERA of Contrast Based CT Scan with Histopathological Correlation: A Study in Tertiary Care Hospital

2021 ◽  
Vol 6 (10) ◽  
pp. 668-673
Author(s):  
Ashraf Amirali ◽  
Jaideep Darira ◽  
Hina Pathan ◽  
Sorath Murtaza ◽  
Munaza Irshad
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Ct Scan ◽  
Predictive Value ◽  
Gold Standard ◽  
Wilms Tumor ◽  
Diagnostic Evaluation ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

The aim of the study is the assessment of accuracy for the diagnostic evaluation of Wilms tumor in the pediatric population in the era of contrast-enhanced CT scan using histopathology as a gold standard. Plain and contrast-enhanced abdominal Computed Tomography including pelvis and chest was performed in suspected patients with multiple axial sections with sagittal and coronal reconstructions. Patients were being followed, data was collected and recorded on proforma after histopathology. The patient's mean age for this study in years was 3.5 ± 1.2. Gender distribution showed 170 patients (54.6%) were male while the remaining 141 patients (45.33%) were female. Contrast-enhanced computed tomography showed sensitivity (90.36%), specificity (51.72%), diagnostic accuracy (72.34%), positive predictive value (68.18%), and negative predictive value (82.42%) confirmed on Histopathology as the gold standard. It is concluded from the results of this study that contrast-enhanced computed tomography proved high diagnostic accuracy positive predictive in the detection of Wilms’ tumor by taking histopathology as the gold standard.

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