A Comparative Diagnostic Performance of Non-contrast and Contrast Enhanced CT for Diagnosis of Acute Appendicitis
Keywords:
acute appendicitis, computed tomography, contrast mediaAbstract
Objective: The main purpose of this study was to compare the diagnostic performance of non-contrast enhanced CT (NECT) and contrast enhanced CT (CECT) for diagnosis of acute appendicitis.
Material and Method: A diagnostic test study design was conducted, 129 patients were enrolled in the study, admitted with abdominal pain and underwent abdominal CT scan during January to March 2024. Retrospectively reviewed the computed tomographic findings and made an imaging diagnosis based on first with NECT and second with CECT. Accuracy and sensitivity of diagnosis was calculated compare to a pathological result or a final diagnosis written in the summary discharge.
Results: The respective sensitivity, specificity, and accuracy for NECT and CECT the diagnosis of acute appendicitis were 98%, 100%, and 99.22%; 98%, 97.47% and 97.67% There was no significant difference in the diagnosis of acute appendicitis among the 2 techniques (p=0.3472).
Conclusions: This study allowed direct comparison between NECT and CECT. There was no difference in the ability of each CT technique for diagnosing patients with acute appendicitis. For a patient whom iodinated contrast media is contraindicated or a patient who has an increased risk of severe adverse reaction, we would encourage the use of NECT because it provides comparable diagnostic performance without further exposing such patient to the contrast media.
References
Nacenta SB, Sanz LI, Lucas RS, Depetris M, Chamorro EM. Update on acute appendicitis: Typical and untypical findings. Radiologia (Engl Ed) 2023;65(suppl 1):S81-S91. doi:10.1016/j.rxeng.2022.09.010.
Bahrami M, Mirgaloyebayat H, Mohajeri Z, Mohammadi H, Afshari SA, Fazeli P, et al. The diagnostic value of the computed tomography scan and ultrasonography in acute appendicitis. Am J Nucl Med Mol Imaging 2023;13(1):11-17.
Jutarat Norasetsingh. Diagnostic value of ultrasound in patients suspected acute appendicitis. Medical Journal Of Srisaket Surin Buriram Hospitals 2022;37(1):149-58.
Iamwat J, Teerasamit W, Apisarnthanarak P, Noppakunsomboon N, Kaewlai R. Predictive ability of CT findings in the differentiation of complicated and uncomplicated appendicitis: a retrospective investigation of 201 patients undergone appendectomy at initial admission. Insights into imaging 2021;12(1):143. doi:10.1186/s13244-021-01086-3.
D'Ippolito G, Mello GGNd, Szejnfeld J. The value of unenhanced CT in the diagnosis of acute appendicitis. Sao Paulo Med J 1998;116(6):1838-45. doi:10.1590/s1516-31801998000600003.
Ege G, Akman H, Sahin A, Bugra D, Kuzucu K. Diagnostic value of unenhanced helical CT in adult patients with suspected acute appendicitis. Br J Radiol 2002;75(897):721-5. doi:10.1259/bjr.75.897.750721.
Malone Jr A, Wolf C, Malmed A, Melliere B. Diagnosis of acute appendicitis: value of unenhanced CT. AJR Am J Roentgenol 1993;160(4):763-6. doi:10.2214/ajr.160.4.8456661.
Poosiri S, Krisanachinda A, Khamwan K. Evaluation of patient radiation dose and risk of cancer from CT examinations. Radiol Phys Technol 2024;17(1):176-85. doi:10.1007/s12194-023-00763-w.
Schultz CH, Fairley R, Murphy LS-L, Doss M. The risk of cancer from CT scans and other sources of low-dose radiation: A critical appraisal of methodologic quality. Prehosp Disaster Med 2020;35(1):3-16. doi:10.1017/S1049023X1900520X.
Hu Y, Ma M, Yin H, Ren P, Tian X, Zheng Z, et al. Assessment of cumulative cancer risk attributable to diagnostic X-ray radiation: a large cohort study. Eur Radiol 2023;33(3):1769-78. doi:10.1007/s00330-022-09178-4.
De Gonzalez AB, Darby S. Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries. Lancet 2004;363(9406):345-51. doi:10.1016/S0140-6736(04)15433-0.
Chen Y, Yang J, Cong R, Wang M, Xiao J, Zhu J, et al. Comparison of contrast-enhanced versus non-enhanced helical computed tomography in the diagnosis of acute appendicitis: A Meta-analysis. J Coll Physicians Surg Pak 2023;33(2):205-11. doi:10.29271/jcpsp.2023.02.205.
Faul F, Erdfelder E, Lang A-G, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39(2):175-91. doi:10.3758/bf03193146.
Eurboonyanun K, Rungwiriyawanich P, Chamadol N, Promsorn J, Eurboonyanun C, Srimunta P. Accuracy of nonenhanced CT vs contrast-enhanced CT for diagnosis of acute appendicitis in adults. Curr Probl Diagn Radiol 2021;50(3):315-20. doi:10.1067/j.cpradiol.2020.01.010.
Charuswattanakul S, Chulroek T. Comparative accuracy of unenhanced and IV-contrast enhanced MDCT in detection of acute appendicitis in adult patients. Chula Med J 2022;66(1):33-42.
Kaiser S, Finnbogason T, Jorulf HK, Soderman E, Frenckner B. Suspected appendicitis in children: diagnosis with contrast-enhanced versus nonenhanced helical CT. Radiology 2004;231(2):427-33. doi:10.1148/radiol.2312030240.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Srinagarind Medical Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
