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Abdominal Imaging

, Volume 32, Issue 6, pp 701–704 | Cite as

Hyperdense appendix on unenhanced CT: a sign of acute appendicitis

  • Suk-Ping Ng
  • She-Meng Cheng
  • Fei-Shih Yang
  • Chi-Yuan Tzen
  • Jon-Kway Huang
Article

Abstract

The purpose of this study was to evaluate the presence of the hyperdense appendix in acute appendicitis. The CT scans of 183 patients with pathologically proven acute appendicitis were reviewed to determine the prevalence of a hyperdense appendix, defined as a high-attenuated appendix when compared with the adjacent cecal wall on precontrast CT. A control group consisted of 100 patients with CT examinations performed in the emergency department were also randomly allocated to search for any hyperdense appendix in other disease conditions. The images were reviewed by two radiologists who reached a decision by consensus. A hyperdense appendix sign was found in 61 of 183 (33%) patients, including 92 men and 91 women ranging in age from 17 to 85 years (mean 37 years). On the other hand, the sign was seen in only two (2%) of the 88 patients in whom appendicitis was not diagnosed. The hyperdense appendix sign on unenhanced CT is seen in about 33% of patients with acute appendicitis. The false-positive rate is very low, rendering it a very useful sign for diagnosis of acute appendicitis.

Keywords

Appendicitis Computed tomography Hemorrhage Hyperdense Unenhanced 

References

  1. 1.
    Shapiro MP, Gale ME, Gerzof SG (1989) CT of appendicitis: diagnosis and treatment. Radiol Clin North Am 27:753–762PubMedGoogle Scholar
  2. 2.
    Ernst O, Bulois P, Saint-Drenant S, et al. (2003) Helical CT in acute lower gastrointestinal bleeding. Eur J Radiol 13:114–117Google Scholar
  3. 3.
    Cobelli R, Zompatori M, De Luca G, et al. (2005) Clinical usefulness of computed tomography study without contrast injection in the evaluation of acute pulmonary embolism. J Comput Assist Tomogr 29:6–12PubMedCrossRefGoogle Scholar
  4. 4.
    Cheng SM, Ng SP, Shih SL (2004) Hyperdense gallbladder wall sign: an overlooked sign of acute cholecystitis on unenhanced CT examination. Clin Imaging 28:128–131PubMedCrossRefGoogle Scholar
  5. 5.
    Wiesner W, Khurana B, Ji H, et al. (2003) CT of acute bowel ischemia. Radiology 226:635–650PubMedCrossRefGoogle Scholar
  6. 6.
    Lane MJ, Mindelzun RE (1999) Appendicitis and its mimickers. Semin Ultrasound CT MR 20:77–85PubMedCrossRefGoogle Scholar
  7. 7.
    Macari M, Balthazar EJ (2003) The acute right lower quadrant: CT evaluation. Radiol Clin North Am 41:1117–1136PubMedCrossRefGoogle Scholar
  8. 8.
    Rao PM, Rhea JT, Novelline RA (1997) Sensitivity and specificity of the individual CT signs of appendicitis: experience with 200 helical appendiceal CT examinations. J Comput Assist Tomogr 21:686–692PubMedCrossRefGoogle Scholar
  9. 9.
    Balthazar EJ, Megibow AJ, Gordon RB, et al. (1988) Computer tomography of the abnormal appendix. J Comput Assist Tomogr 12:595–601PubMedCrossRefGoogle Scholar
  10. 10.
    Cakirer S, Basak M, Colakoglu B, et al. (1993) Diagnosis of acute appendicitis: value of unenhanced CT. Am J Roentgenol 160:763–766Google Scholar
  11. 11.
    Chou CK, Mak CW, Tzeng WS, et al. (2004) CT of small bowel ischemia. Abdom Imaging 29:18–22PubMedCrossRefGoogle Scholar
  12. 12.
    Frager DH, Baer JW (1995) Role of CT in evaluating patients with small-bowel obstruction. Semin Ultrasound CT MR 16:127–140PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Suk-Ping Ng
    • 1
    • 2
  • She-Meng Cheng
    • 1
    • 2
  • Fei-Shih Yang
    • 1
  • Chi-Yuan Tzen
    • 2
    • 3
    • 4
  • Jon-Kway Huang
    • 1
  1. 1.Department of RadiologyMackay Memorial HospitalTaipeiTaiwan
  2. 2.Mackay MedicineNursing and Management CollegeTaipeiTaiwan
  3. 3.Department of PathologyMackay Memorial HospitalTaipeiTaiwan
  4. 4.National Taipei College of NursingTaipeiTaiwan

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