The value multi-detector row CT of the abdomen in preoperative evaluation of acute appendicitis, radiological and post-surgical pathological correlation

الملخص EN

Background : To assess the accuracy of multi-detector row CT (MDCT) of the abdomen in the diagnosis and preoperative evaluation of acute appendicitis with post-surgical pathological correlation.

Material and Methods : 35 consecutive patients (22 men and 13 women ; mean age, 32 years) underwent 64-slice MDCT examinations of the abdomen.

Non-enhanced spiral CT of the abdomen was performed.

Then, 120 mL of nonionic contrast material was injected at a rate of 3-4mL / sec.

Arterial and portal venous phase volumetric data sets were acquired at 25-30 seconds and 70-75 seconds after start of contrast injection respectively.

Volumetric reconstructions were performed at a CT workstation for the 2 mm sections of the arterial and portal venous phases.

These included coronal and sagittal overlapping thin MIP as well as 3D MIP reconstructions.

Each scan was evaluated independently for the presence of inflammatory process (appendicitis), and associated complications.

The radiological findings at CT were compared with those at surgery and the histopathological results to verify the efficacy of 64-slice MDCT in the preoperative evaluation of the acute appendicitis on the basis of surgical and histopathological findings.

Results : 23 out of 35 patients referred from the emergency department received CT diagnosis of appendicitis ; 15 patients showed local inflammatory changes at the appendicular and ileocaecal regions, 5 patients had appendicular abscess, and 3 showed appendicular mass formation.

12 patients received alternative diagnoses (3 ovarian cysts, 1 Chron's disease, 5 ureteric calculi, and 3 nonspcific findings).

Conclusion : MDCT can be used effectively in the preoperative evaluation of appendicitis and provides high accuracy for detecting its complications guiding the treating physicians for the proper management of these patients.