Skip to main content
Log in

MDCT diagnosis of appendicitis using only coronal reformations

  • Original Article
  • Published:
Emergency Radiology Aims and scope Submit manuscript

Abstract

The purpose of this study was to assess the feasibility of diagnosing appendicitis based on coronal reformations without the aid of transverse images. Abdominal and pelvic computed tomography (CT) scans of 53 patients (27 with appendicitis and 26 without appendicitis) were reviewed. All scans were obtained using a four-slice multi-detector row CT. The radiologists were not aware of the final diagnosis. Cases were reviewed for the visualization of the appendix and presence of appendicitis. All images were reviewed on picture archiving and communication systems. There were no false positives for diagnosing appendicitis when using either the transverse or coronal reformations. Appendicitis was not seen on the coronal images in one case, and there were no false negatives when transverse reformations alone were used. This difference was not statistically significant (p < 0.0001 for both modes of display). The sensitivity for diagnosing appendicitis based on the coronal images alone was 96%, the specificity was 100%, and the accuracy was 98%. Coronal reformations decreased the number of images reviewed by 19%. CT diagnosis of appendicitis based on the coronal images is accurate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Sarosi GA, Turnage RH (2002) Appendicitis. In: Feldman M, Friedman LS, Sleisenger MH (ed) Sleisenger & Fordtran’s gastrointestinal and liver disease, 7th edn. Saunders, Philadelphia, pp 2089–2099

    Google Scholar 

  2. Lane MJ, Liu DM, Huynh MD, Jeffrey RB, Jr., Mindelzun RE, Katz DS (1999) Suspected acute appendicitis: nonenhanced helical CT in 300 consecutive patients. Radiology 213:341–346

    PubMed  CAS  Google Scholar 

  3. Velanovich V, Satava R (1992) Balancing the normal appendectomy rate with the perforated appendicitis rate: implications for quality assurance. Am Surg 58:264–269

    PubMed  CAS  Google Scholar 

  4. Graff L, Russell J, Seashore J et al (2000) False-negative and false-positive errors in abdominal pain evaluation: failure to diagnose acute appendicitis and unnecessary surgery. Acad Emerg Med 7:1244–1255

    PubMed  CAS  Google Scholar 

  5. Rusnak RA, Borer JM, Fastow JS (1994) Misdiagnosis of acute appendicitis: common features discovered in cases after litigation. Am J Emerg Med 12:397–402

    Article  PubMed  CAS  Google Scholar 

  6. Von Titte SN, McCabe CJ, Ottinger LW (1996) Delayed appendectomy for appendicitis: causes and consequences. Am J Emerg Med 14:620–622

    Article  Google Scholar 

  7. Brandt MM, Wahl WL (2003) Liberal use of CT scanning helps to diagnose appendicitis in adults. Am Surg 69:727–731

    PubMed  Google Scholar 

  8. Paulson EK, Kalady MF, Pappas TN (2003) Suspected appendicitis. N Engl J Med 348:236–242

    Google Scholar 

  9. Shelton T, McKinlay R, Schwartz RW (2003) Acute appendicitis: current diagnosis and treatment. Curr Surg 60:502–505

    Article  PubMed  Google Scholar 

  10. Torbati SS, Guss DA (2003) Impact of helical computed tomography on the outcomes of emergency department patients with suspected appendicitis. Acad Emerg Med 10:823–829

    Article  PubMed  Google Scholar 

  11. Balthazar EJ, Rofsky NM, Zucker R (1998) Appendicitis: the impact of computed tomography imaging on negative appendectomy and perforation rates. Am J Gastroenterol 93:768–771

    Article  PubMed  CAS  Google Scholar 

  12. Rao PM, Rhea JT, Novelline RA, Mostafavi AA, McCabe CJ (1998) Effect of computed tomography of the appendix on treatment of patients and use of hospital resources. N Engl J Med 338:141–146

    Article  PubMed  CAS  Google Scholar 

  13. Hu H, He HD, Foley WD, Fox SH (2000) Four multidetector-row helical cT: image quality and volume coverage speed. Radiology 215:55–62

    PubMed  CAS  Google Scholar 

  14. Flohr TG, Schaller S, Stierstorfer K, Bruder H, Ohnesorge BM, Schoepf UJ (2005) Multi-detector row CT systems and image-reconstruction techniques. Radiology 235:756–773

    Article  PubMed  Google Scholar 

  15. Jaffe TA, Nelson RC, Johnson GA et al (2006) Optimization of multiplanar reformations from isotropic data sets acquired with 16-detector row helical CT scanner. Radiology 238:292–299

    Article  PubMed  Google Scholar 

  16. Rydberg J, Buckwalter KA, Caldemeyer KS et al (2000) Multisection CT: scanning techniques and clinical applications. RadioGraphics 20:1787–1806

    PubMed  CAS  Google Scholar 

  17. Paulson EK, Jaffe TA, Thomas J, Harris JP, Nelson RC (2004) MDCT of patients with acute abdominal pain: a new perspective using coronal reformations from submillimeter isotropic voxels. Am J Roentgenol 183:899–906

    Google Scholar 

  18. Jan YT, Yang FS, Huang JK (2005) Visualization rate and pattern of normal appendix on multidetector computed tomography by using multiplanar reformation display. J Comput Assist Tomogr 29:446–451

    Article  PubMed  Google Scholar 

  19. Paulson EK, Harris JP, Jaffe TA, Haugan PA, Nelson RC (2005) Acute appendicitis: added diagnostic value of coronal reformations from isotropic voxels at multi-detector row CT. Radiology 235:879–885

    Article  PubMed  Google Scholar 

  20. Kundra V, Silverman PM (2003) Impact of multislice CT on imaging of acute abdominal disease. Radiol Clin North Am 41:1083–1093

    Article  PubMed  Google Scholar 

  21. Schmidt S, Chevallier P, Chalaron M et al (2005) Multidetector CT enteroclysis: comparison of the reading performance for axial and coronal views. Eur Radiol 15:238–246

    Article  PubMed  Google Scholar 

  22. Rubin GD (2000) Data explosion: the challenge of multidetector-row CT. Eur J Radiol 36:74–80

    Article  PubMed  CAS  Google Scholar 

  23. Sherbondy AJ, Holmlund D, Rubin GD, Schraedley PK, Winograd T, Napel S (2005) Alternative input devices for efficient navigation of large CT angiography data sets. Radiology 234:391–398

    Article  PubMed  Google Scholar 

  24. Lee KH, Kim YH, Hahn S et al (2006) Added value of coronal reformations for duty radiologists and for referring physicians or surgeons in the CT diagnosis of acute appendicitis. Korean J Radiol 7:87–96

    Article  PubMed  Google Scholar 

  25. Nikolaidis P, Hwang CM, Miller FH, Papanicolaou N (2004) The nonvisualized appendix: incidence of acute appendicitis when secondary inflammatory changes are absent. Am J Roentgenol 183:889–892

    Google Scholar 

  26. Jacobs JE, Birnbaum BA, Macari M et al (2001) Acute appendicitis: comparison of helical CT diagnosis—focused technique with oral contrast material versus nonfocused technique with oral and intravenous contrast material. Radiology 220:683–690

    Article  PubMed  CAS  Google Scholar 

  27. Birnbaum BA, Wilson SR (2000) Appendicitis at the millennium. Radiology 215:337–348

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Vahid Yaghmai.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yaghmai, V., Brandwein, W.M., Hammond, N. et al. MDCT diagnosis of appendicitis using only coronal reformations. Emerg Radiol 14, 167–172 (2007). https://doi.org/10.1007/s10140-007-0610-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10140-007-0610-4

Keywords

Navigation