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Diagnosis of appendiceal diverticulitis by multidetector computed tomography

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Abstract

Purpose

Because appendiceal diverticulitis (AD) has a high risk of perforation, precise diagnosis is important for patients with suspected acute appendicitis (AA). In this study, we aimed to reveal the characteristics of computed tomography (CT) images of AD.

Methods

CT images were comparatively analyzed in patients who underwent appendectomy and had histopathologically proved AD (n = 23) or AA (n = 365) to reveal specific findings of CT image for AD and determine sensitivity and specificity of CT for AD.

Results

Univariate analysis showed that maximal diameter of the appendix in AD was significantly smaller than that in AA. Multivariate analysis showed that saccular structure of the appendix wall, cecum or ascending colon diverticulum and peri-appendiceal or -cecal fluid collection were significant independent indicators of AD. Based on that saccular structure of the appendix wall which was the most important specific finding, the sensitivity and specificity of CT for AD were 48% and 99%, respectively.

Conclusion

The saccular structure of the appendix wall, cecum or ascending colon diverticulum and peri-appendiceal or -cecal fluid collection in CT suggest AD in patients with suspected AA. The sensitivity and specificity of CT for diagnosing AD were 48% and 99%, respectively.

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Authors and Affiliations

  1. Department of Surgery, Japanese Red Cross Nagoya First Hospital, Nakamura-ku Michisita3-35, Nagoya, Aichi, Japan

    Koji Fukata, Hideo Miyake, Hidemasa Nagai, Yuichiro Yoshioka & Norihiro Yuasa

  2. Department of Laboratory Medicine, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan

    Junichi Takamizawa

  3. Department of Radiology, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan

    Shigeki Ito

  4. Department of Pathology, Japanese Red Cross Nagoya First Hospital, Nagoya, Aichi, Japan

    Masahiko Fujino

Authors
  1. Koji Fukata
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  2. Junichi Takamizawa
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  3. Hideo Miyake
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  4. Hidemasa Nagai
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  5. Yuichiro Yoshioka
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  6. Norihiro Yuasa
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  7. Shigeki Ito
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  8. Masahiko Fujino
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Corresponding author

Correspondence to Norihiro Yuasa.

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The authors declare that they have no conflict of interest.

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The study protocol was reviewed and approved by the institutional review boards.

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Fukata, K., Takamizawa, J., Miyake, H. et al. Diagnosis of appendiceal diverticulitis by multidetector computed tomography. Jpn J Radiol 38, 572–578 (2020). https://doi.org/10.1007/s11604-020-00950-4

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  • DOI: https://doi.org/10.1007/s11604-020-00950-4

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