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Evaluation of a low-dose CT protocol with oral contrast for assessment of acute appendicitis

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Abstract

The aim of this study was to evaluate a low-dose CT with oral contrast medium (LDCT) for the diagnosis of acute appendicitis and compare its performance with standard-dose i.v. contrast-enhanced CT (standard CT) according to patients’ BMIs. Eighty-six consecutive patients admitted with suspicion of acute appendicitis underwent LDCT (30 mAs), followed by standard CT (180 mAs). Both examinations were reviewed by two experienced radiologists for direct and indirect signs of appendicitis. Clinical and surgical follow-up was considered as the reference standard. Appendicitis was confirmed by surgery in 37 (43%) of the 86 patients. Twenty-nine (34%) patients eventually had an alternative discharge diagnosis to explain their abdominal pain. Clinical and biological follow-up was uneventful in 20 (23%) patients. LDCT and standard CT had the same sensitivity (100%, 33/33) and specificity (98%, 45/46) to diagnose appendicitis in patients with a body mass index (BMI) ≥ 18.5. In slim patients (BMI < 18.5), sensitivity to diagnose appendicitis was 50% (2/4) for LDCT and 100% (4/4) for standard CT, while specificity was identical for both techniques (67%, 2/3). LDCT may play a role in the diagnostic workup of patients with a BMI ≥ 18.5.

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Authors and Affiliations

  1. Department of Radiology, University Hospital of Geneva, 24, rue Micheli-du-Crest, 1211, Geneva 14, Switzerland

    Alexandra Platon, Helmi Jlassi, Christoph D. Becker & Pierre-Alexandre Poletti

  2. Emergency Center, University Hospital of Geneva, Geneva, Switzerland

    Olivier T. Rutschmann

  3. University Institute for Radiation Physics, Lausanne, Switzerland

    Francis R. Verdun

  4. Clinic of Digestive Surgery, University Hospital of Geneva, Geneva, Switzerland

    Pascal Gervaz

Authors
  1. Alexandra Platon
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  2. Helmi Jlassi
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  3. Olivier T. Rutschmann
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  4. Christoph D. Becker
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  5. Francis R. Verdun
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  6. Pascal Gervaz
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  7. Pierre-Alexandre Poletti
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Correspondence to Pierre-Alexandre Poletti.

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This paper was supported by the grant for Research and Development of the University Hospital of Geneva

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Platon, A., Jlassi, H., Rutschmann, O.T. et al. Evaluation of a low-dose CT protocol with oral contrast for assessment of acute appendicitis. Eur Radiol 19, 446–454 (2009). https://doi.org/10.1007/s00330-008-1164-x

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  • DOI: https://doi.org/10.1007/s00330-008-1164-x

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