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  • Title: Computed tomography diagnosis of acute appendicitis: advantages of reviewing thin-section datasets using sliding slab average intensity projection technique.
    Author: Lee KH, Kim YH, Hahn S, Lee KW, Kim TJ, Kang SB, Shin JH.
    Journal: Invest Radiol; 2006 Jul; 41(7):579-85. PubMed ID: 16772851.
    Abstract:
    OBJECTIVES: We sought to compare sliding slab mode and standard stack mode in the computed tomography (CT) diagnosis of acute appendicitis. MATERIALS AND METHODS: Contrast-enhanced CT was performed in 85 patients, 35 of whom had appendicitis. Four readers retrospectively reviewed 5-mm thick transverse sections (4-mm increment) using the stack mode and 2-mm thick sections (1-mm increment) with the sliding slab, average intensity projection. The sliding slab mode started with a 5-mm thick transverse slab, but the readers were encouraged to change the viewing angle and the slab thickness. RESULTS: In sliding slab mode, the readers changed the viewing angle in 89 of 340 observations (24%) and decreased the slab thickness in 26 observations (8%). Although the receiver operating characteristic analysis did not show a significant difference (P = 0.18), the sliding slab mode enhanced the pooled sensitivity (93.6% vs. 98.6%, P = 0.02), specificity (92.0% vs. 97.5%, P = 0.01), and mean confidence for the diagnosis (P < 0.001) or exclusion (P = 0.002) of acute appendicitis; reduced inconclusive interpretations (5.6% vs. 1.8%, P = 0.01); and visualized the appendix more clearly (P < 0.001). CONCLUSIONS: Compared with the stack mode, the sliding slab mode enhances diagnostic confidence and more clearly visualizes the appendix.
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