J Korean Soc Emerg Med.  2001 Sep;12(3):290-297.

Comparison of Computer Tomography and Sonography in Patients Suspected of Having Appendicitis

• Lee JH
• Choi PC
• Shim MS
• Song KJ
• Jeong YK

Abstract

BACKGROUND: This study was conducted to compare the accuracy of computered tomography(CT) and sonography(US) in diagnosing acute appendicitis and to analyze the radiologic factors which influence the result.
METHODS
We retrospectively studied the cases of 53 patients who were suspected of having appendicitis and who were examined by CT and US covered a three-year period. The final diagnosis was determined from the surgico-pathologic diagnosis and clinical follow-up for two months, as well as from the discharge diagnosis.
RESULTS
Thirty-eight(38) patients had acute appendicitis; 15 patients did not. In the analysis, CT and US, respectively, revealed sensitivities of 89.5% and 73.7%, specificities of 93.3% and 60.0%, positive predictive values of 97.1% and 82.4%, negative predictive values of 77.8% and 47.4%. Among patients diagnosed with acute appendicitis, 10 patients were discordant in the US and the CT examinations; CT findings were correct in 8 and US findings in 2. Among non-appendicitis patients, 5 patients were discordant in the US and the CT examinations; CT was correct in 5 and US in 0. Nighteen(19) patients had complications such as an abscess or a perforation. Among these patients, the degree and the extent of the complication were accurately evaluated by CT in 15 patients and by US in 5 patients.
CONCLUSION
CT is more accurate than US in diagnosing and excluding acute appendicitis. The use of CT will substantially decrease unnecessary laparotomies and post-operation complications.

Keyword

Acute appendicitis; Comparison; CT; US; Negative Appendectomy

MeSH Terms

Abscess
Appendicitis*
Diagnosis
Follow-Up Studies
Humans
Laparotomy
Retrospective Studies