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Multidetector CT Scan Diagnostic of Appendicitis

Multidetector computed tomography is highly sensitive and specific for suspected appendicitis

TUESDAY, June 21 (HealthDay News) -- Multidetector computed tomography (MDCT) is a highly sensitive and specific test for routine evaluation of suspected appendicitis in adults, according to a study published in the June 21 issue of the Annals of Internal Medicine.

Perry J. Pickhardt, M.D., from the University of Wisconsin School of Medicine and Public Health in Madison, and colleagues evaluated the diagnostic performance of MDCT for suspected acute appendicitis in 2,871 adults. Nonfocused abdominopelvic MDCT scans were carried out between 2000 and 2009, and interpreted by radiologists who were aware of the study indication. Diagnostic performance of MDCT was compared to the reference standard of final combined clinical, surgical, and pathology findings.

The investigators found that 675 (23.5 percent) of the patients had confirmed acute appendicitis. The MDCT was 98.5 percent sensitive and 98.0 percent specific. The positive and negative predictive values of MDCT were 93.9 and 99.5 percent, respectively, with positive and negative likelihood ratios of 51.3 and 0.015, respectively. Negative findings at appendectomy were present in 7.5 percent of cases, which would have decreased to 4.1 percent had 26 cases with true-negative MDCT findings not undergone surgery. The perforation rate decreased from 28.9 percent in 2000 to 11.5 percent in 2009, and was 17.8 percent overall. Of the 2,122 patients without appendicitis or appendectomy, MDCT could provide or suggest an alternative diagnosis in 893 patients (42.1 percent).

"Standard nonfocused MDCT of the abdomen and pelvis is a highly sensitive and specific test in the setting of suspected acute appendicitis in both men and women," the authors write.

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