NONCONTRAST SPIRAL COMPUTED TOMOGRAPHY FINDINGS OF ACUTE APPENDICITIS

Abstract

Patients who have clinical findings of acute abdomen and pre-diagnosis of acute appendicitis in our emergency surgical unit are included in our prospective study. In the diagnostic approach, conventionally used methods are not accurate enough and the result is the high ratio of unnecessary appendectomies. Our aim was to investigate the diagnostic efficacy of spiral CT examination as a supportive method. Over an 18 month period 65 patients who had acute appendicitis diagnosis via conventional methods received a non-contrast enhanced CT examination in a single breath hold period between levels of umbilicus and symphisis pubis with a slice thickness of 5 mm. The findings of the CT examination were compared with clinical observations, surgical and pathological results. 43 true-positive, 17 true-negative, 3 false-negative and 2 false positive results were obtained. The sensitivity was 93.4% and specificity 89.4%. In our study we have found out that without the spiral CT examination 14 of our patients (%21.5) would have had unnecessary laparatomy. With the addition of non-contrast enhanced spiral CT examination, the ratio of false positive and false negative diagnoses decreased to 7.6% non-contrast enhanced spiral CT adds an important diagnostic value to conventional methods.