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  • Title: Suspected acute appendicitis: is ultrasonography or computed tomography the preferred imaging technique?
    Author: Pickuth D, Heywang-Köbrunner SH, Spielmann RP.
    Journal: Eur J Surg; 2000 Apr; 166(4):315-9. PubMed ID: 10817330.
    Abstract:
    OBJECTIVE: To compare the sensitivity and specificity of unenhanced spiral computed tomography (CT) and ultrasonography (US) in patients with suspected acute appendicitis. DESIGN: Prospective study. SETTING: University hospital, Germany. SUBJECTS: 120 consecutive patients with acute appendicitis as a differential diagnosis, whose clinical findings were not enough to make operation essential, but were too severe to send home. INTERVENTIONS: CT and US of the appendix. MAIN OUTCOME MEASURES: Sensitivity, specificity, and positive and negative predictive value. RESULTS: The results were correlated with surgical and histopathological findings at appendicectomy or clinical follow-up. 93 patients had acute appendicitis, 27 patients did not. The sensitivity of CT was 95% and of US 87%. The corresponding specificities were 89% and 74%, positive predictive values 97% and 92%, negative predictive values 83% and 63%. In the 27 patients who did not have acute appendicitis, the correct diagnosis was established with CT in 14 patients and with US in eight. CONCLUSION: CT is more sensitive and specific than US in patients suspected of having acute appendicitis, but in whom the presentation is equivocal. The use of unenhanced spiral CT led to a significant improvement in the accuracy of preoperative diagnosis and a lower negative appendicectomy rate.
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