J Korean Soc Emerg Med.  2008 Dec;19(6):724-730.

The Benefit of Added Coronal Reformation Images in the MDCT Diagnosis of Acute Appendicitis for Emergency Physicians

• Park JH
• Youn CS
• Wee JH
• Kim JH
• Kim YM
• Choi SP
• Park KN
• Kim HJ

Abstract

PURPOSE: We compared diagnostic accuracy using transverse scans and combined transverse and coronal reformation images in the MDCT diagnosis of acute appendicitis.
METHODS
MDCT was performed in 100 patients with acute non-traumatic abdominal pain who visited the emergency department. One half was diagnosed acute appendicitis by radiologic and histologic findings and the other half was not. Transverse scan and combined transverse and coronal reformation images were interpreted by six emergency physicians. Emergency physicians included two board physicians, two senior residents, and two junior residents. For comparison of diagnostic value, the chi-square test and cross tabs test were done.
RESULTS
For all emergency physicians except one senior resident, the added coronal reformation images tended to increase the diagnostic accuracy. For board physicians, it increased the diagnostic accuracy from 81.5% to 91% (p=0.003). Senior residents increased from 82.5% to 91.5% (p=0.005), junior residents increased from 75.5% to 87% (p=0.002). The diagnostic accuracy of board physicians and senior residents were higher than junior residents for both image types.
CONCLUSION
Coronal reformation images improve the accuracy of emergency physicians in the MDCT diagnosis of acute appendicitis.

Keyword

Appendicitis; Computed tomography; Image processing

MeSH Terms

Abdominal Pain
Appendicitis
Emergencies
Humans