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Up-to-Date Diagnostic CT Standards for Acute Appendicitis: Wall Thickness and Intraluminal Fluid Thickness

Acute appendicitis is a prevalent condition that requires accurate and timely diagnosis and management to avoid potential complications. Classically, the diagnosis of appendicitis is made using the appendicular outer-to-outer wall diameter. In this study, we examined the sensitivity and specificity...

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Autores principales: Wazzan, Mohammad, Abduljabbar, Ahmed, Khizindar, Huda, Alzahrani, Aghnar, Aljohani, Renad M, Nahas, Rana, Aman, Rahf, Tawfiq, Shouq, Aldajani, Arwa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10643053/
https://www.ncbi.nlm.nih.gov/pubmed/37965237
http://dx.doi.org/10.7759/cureus.48154
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author Wazzan, Mohammad
Abduljabbar, Ahmed
Khizindar, Huda
Alzahrani, Aghnar
Aljohani, Renad M
Nahas, Rana
Aman, Rahf
Tawfiq, Shouq
Aldajani, Arwa
author_facet Wazzan, Mohammad
Abduljabbar, Ahmed
Khizindar, Huda
Alzahrani, Aghnar
Aljohani, Renad M
Nahas, Rana
Aman, Rahf
Tawfiq, Shouq
Aldajani, Arwa
author_sort Wazzan, Mohammad
collection PubMed
description Acute appendicitis is a prevalent condition that requires accurate and timely diagnosis and management to avoid potential complications. Classically, the diagnosis of appendicitis is made using the appendicular outer-to-outer wall diameter. In this study, we examined the sensitivity and specificity of computed tomography (CT) scans for diagnosing acute appendicitis using wall thickness and lumen thickness rather than diameter. This study included data from 350 patients who presented to the emergency department with clinically suspected acute appendicitis. All patients underwent a CT scan, and 62 radiologically positive patients underwent surgery. A radiological diagnosis was made using the conventional outer-to-outer wall diameter with a cut-off of 6 mm for a positive diagnosis. These 62 positive CT scans were reviewed and compared with surgical results. The study showed that a threshold of 2.25 mm for appendicular lumen thickness is an excellent diagnostic tool for acute appendicitis, demonstrating a high sensitivity of 96.4% and a lower specificity of 67%. In contrast, 1.6 mm wall thickness indicates acute appendicitis, with 81.8% sensitivity and 84% specificity. However, the wall thickness remains inferior to the conventionally used measurement of 6.75 mm for appendicular diameter, with a sensitivity of 87.5% and a specificity of 100%.
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spelling pubmed-106430532023-11-14 Up-to-Date Diagnostic CT Standards for Acute Appendicitis: Wall Thickness and Intraluminal Fluid Thickness Wazzan, Mohammad Abduljabbar, Ahmed Khizindar, Huda Alzahrani, Aghnar Aljohani, Renad M Nahas, Rana Aman, Rahf Tawfiq, Shouq Aldajani, Arwa Cureus Radiology Acute appendicitis is a prevalent condition that requires accurate and timely diagnosis and management to avoid potential complications. Classically, the diagnosis of appendicitis is made using the appendicular outer-to-outer wall diameter. In this study, we examined the sensitivity and specificity of computed tomography (CT) scans for diagnosing acute appendicitis using wall thickness and lumen thickness rather than diameter. This study included data from 350 patients who presented to the emergency department with clinically suspected acute appendicitis. All patients underwent a CT scan, and 62 radiologically positive patients underwent surgery. A radiological diagnosis was made using the conventional outer-to-outer wall diameter with a cut-off of 6 mm for a positive diagnosis. These 62 positive CT scans were reviewed and compared with surgical results. The study showed that a threshold of 2.25 mm for appendicular lumen thickness is an excellent diagnostic tool for acute appendicitis, demonstrating a high sensitivity of 96.4% and a lower specificity of 67%. In contrast, 1.6 mm wall thickness indicates acute appendicitis, with 81.8% sensitivity and 84% specificity. However, the wall thickness remains inferior to the conventionally used measurement of 6.75 mm for appendicular diameter, with a sensitivity of 87.5% and a specificity of 100%. Cureus 2023-11-02 /pmc/articles/PMC10643053/ /pubmed/37965237 http://dx.doi.org/10.7759/cureus.48154 Text en Copyright © 2023, Wazzan et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Radiology
Wazzan, Mohammad
Abduljabbar, Ahmed
Khizindar, Huda
Alzahrani, Aghnar
Aljohani, Renad M
Nahas, Rana
Aman, Rahf
Tawfiq, Shouq
Aldajani, Arwa
Up-to-Date Diagnostic CT Standards for Acute Appendicitis: Wall Thickness and Intraluminal Fluid Thickness
title Up-to-Date Diagnostic CT Standards for Acute Appendicitis: Wall Thickness and Intraluminal Fluid Thickness
title_full Up-to-Date Diagnostic CT Standards for Acute Appendicitis: Wall Thickness and Intraluminal Fluid Thickness
title_fullStr Up-to-Date Diagnostic CT Standards for Acute Appendicitis: Wall Thickness and Intraluminal Fluid Thickness
title_full_unstemmed Up-to-Date Diagnostic CT Standards for Acute Appendicitis: Wall Thickness and Intraluminal Fluid Thickness
title_short Up-to-Date Diagnostic CT Standards for Acute Appendicitis: Wall Thickness and Intraluminal Fluid Thickness
title_sort up-to-date diagnostic ct standards for acute appendicitis: wall thickness and intraluminal fluid thickness
topic Radiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10643053/
https://www.ncbi.nlm.nih.gov/pubmed/37965237
http://dx.doi.org/10.7759/cureus.48154
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