Assessment of the Impact of the Amount of Contrast Material Used in Abdominal CT Examinations Regarding the Diagnosis of Appendicolith
- 1. Assistant Professor, Department of Radiology, Lord Buddha Koshi Medical College and Hospital, Saharsa, Bihar, India
- 2. Associate Professor, Department of Radiology, Lord Buddha Koshi Medical College and Hospital, Saharsa, Bihar, India
Description
Aim: The aim of the present study was to investigate the impact of the amount of contrast material used in abdominal CT examinations regarding the diagnosis of appendicolith. Methods: This was a cross-sectional study that was performed to evaluate the diagnostic value of the CT examination in patients with acute appendicitis. One hundred patients that met the inclusion criteria entered the study using census method. Demographic data of patients including age, gender were obtained. Results: In 70 patients, the CT scan findings were favorable for acute appendicitis, and the diagnosis was confirmed by the post-appendectomy pathological testing. Among the individuals undergoing CT scans, 5 false positive and 8 false negative results were recorded. The CT scan revealed that the patients had reduced peritoneal fat as well as a retrocecal appendix. The sensitivity, specificity, positive and negative predictive value of CT scans based on pathology results were 88.6%, 82.8%, 95.5%, and 78.2%, respectively, in patients with low clinical suspicion. We evaluated the CT scan and ultrasonography based on the gender of patients. Conclusion: In the clinical cases that there is suspicion of acute appendicitis, nephrolithiasis and ureterolithiasis, the present study recommends the acquisition of an abdominal CT applying however the following workflow. The CT protocol should apply first a low-dose pelvis CT scan in the region of cecum without contrast material. Subsequently, a second CT scan should be acquired with the use of oral and IV contrast.
Abstract (English)
Aim: The aim of the present study was to investigate the impact of the amount of contrast material used in abdominal CT examinations regarding the diagnosis of appendicolith. Methods: This was a cross-sectional study that was performed to evaluate the diagnostic value of the CT examination in patients with acute appendicitis. One hundred patients that met the inclusion criteria entered the study using census method. Demographic data of patients including age, gender were obtained. Results: In 70 patients, the CT scan findings were favorable for acute appendicitis, and the diagnosis was confirmed by the post-appendectomy pathological testing. Among the individuals undergoing CT scans, 5 false positive and 8 false negative results were recorded. The CT scan revealed that the patients had reduced peritoneal fat as well as a retrocecal appendix. The sensitivity, specificity, positive and negative predictive value of CT scans based on pathology results were 88.6%, 82.8%, 95.5%, and 78.2%, respectively, in patients with low clinical suspicion. We evaluated the CT scan and ultrasonography based on the gender of patients. Conclusion: In the clinical cases that there is suspicion of acute appendicitis, nephrolithiasis and ureterolithiasis, the present study recommends the acquisition of an abdominal CT applying however the following workflow. The CT protocol should apply first a low-dose pelvis CT scan in the region of cecum without contrast material. Subsequently, a second CT scan should be acquired with the use of oral and IV contrast.
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Additional details
Dates
- Accepted
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2023-09-20
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References
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