Maximum outer appendiceal diameter as a criterion of acute appendicitis: Evaluation at computerized tomography

Yu Hui Chiu, Jen Dar Chen, Chui Mei Tiu, Yi Hong Chou, Carlos Lam, Ray Jade Chen

研究成果: 雜誌貢獻文章

1 引文 (Scopus)

摘要

Objective: The goal of this study was to assess the optimum diagnostic cutoff value of maximum outer appendiceal diameter on computed tomography (CT) images in patients with suspected acute appendicitis in the emergency department. Methods: A total of 328 patients with clinical suspicion of appendicitis were retrospectively reviewed. Evaluation of CT images, and chart review for clinical, laboratory, surgical, and pathologic findings were performed. Logistic regression was used to identify possible predictive factors influencing diagnosis of acute appendicitis. The receiver operating characteristic (ROC) curve was applied to determine the most suitable diagnostic cutoff value of appendiceal diameter for acute appendicitis. Results: In a total of 136 patients (41.5%) the diagnosis of acute appendicitis was made; 192 patients (58.5%) had nonacute appendicitis. Mean appendiceal diameter was 12.68±3.31mm in patients with acute appendicitis and 6.01±1.50mm in patients without. The appendiceal diameter had a significantly statistical difference to differentiate the presence from the absence of acute appendicitis with an area under the ROC curve of 0.985 (95% confidence interval, 0.973-0.996). An appendiceal diameter cutoff value of 8.15mm had a sensitivity of 97%, a specificity of 93.2%, and an accuracy of 94.8%. Appendiceal wall enhancement with intravenous contrast medium also had a significantly statistical difference for discriminating patients with acute appendicitis from those without by logistic regression. Conclusion: Detection of maximum outer appendiceal diameter and appendiceal wall enhancement with intravenous contrast medium on CT could help differentiate patients with acute appendicitis from those without. An appendiceal diameter greater than 8.15mm is particularly useful for diagnosis of acute appendicitis.

原文英語
頁(從 - 到)97-100
頁數4
期刊Journal of Experimental and Clinical Medicine(Taiwan)
5
發行號3
DOIs
出版狀態已發佈 - 2013

指紋

Appendicitis
Tomography
ROC Curve
Contrast Media
Logistic Models
Hospital Emergency Service
Confidence Intervals

ASJC Scopus subject areas

  • Medicine(all)

引用此文

Maximum outer appendiceal diameter as a criterion of acute appendicitis : Evaluation at computerized tomography. / Chiu, Yu Hui; Chen, Jen Dar; Tiu, Chui Mei; Chou, Yi Hong; Lam, Carlos; Chen, Ray Jade.

於: Journal of Experimental and Clinical Medicine(Taiwan), 卷 5, 編號 3, 2013, p. 97-100.

研究成果: 雜誌貢獻文章

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title = "Maximum outer appendiceal diameter as a criterion of acute appendicitis: Evaluation at computerized tomography",
abstract = "Objective: The goal of this study was to assess the optimum diagnostic cutoff value of maximum outer appendiceal diameter on computed tomography (CT) images in patients with suspected acute appendicitis in the emergency department. Methods: A total of 328 patients with clinical suspicion of appendicitis were retrospectively reviewed. Evaluation of CT images, and chart review for clinical, laboratory, surgical, and pathologic findings were performed. Logistic regression was used to identify possible predictive factors influencing diagnosis of acute appendicitis. The receiver operating characteristic (ROC) curve was applied to determine the most suitable diagnostic cutoff value of appendiceal diameter for acute appendicitis. Results: In a total of 136 patients (41.5{\%}) the diagnosis of acute appendicitis was made; 192 patients (58.5{\%}) had nonacute appendicitis. Mean appendiceal diameter was 12.68±3.31mm in patients with acute appendicitis and 6.01±1.50mm in patients without. The appendiceal diameter had a significantly statistical difference to differentiate the presence from the absence of acute appendicitis with an area under the ROC curve of 0.985 (95{\%} confidence interval, 0.973-0.996). An appendiceal diameter cutoff value of 8.15mm had a sensitivity of 97{\%}, a specificity of 93.2{\%}, and an accuracy of 94.8{\%}. Appendiceal wall enhancement with intravenous contrast medium also had a significantly statistical difference for discriminating patients with acute appendicitis from those without by logistic regression. Conclusion: Detection of maximum outer appendiceal diameter and appendiceal wall enhancement with intravenous contrast medium on CT could help differentiate patients with acute appendicitis from those without. An appendiceal diameter greater than 8.15mm is particularly useful for diagnosis of acute appendicitis.",
keywords = "Acute appendicitis, Appendiceal diameter, Appendiceal wall enhancement, Computed tomography",
author = "Chiu, {Yu Hui} and Chen, {Jen Dar} and Tiu, {Chui Mei} and Chou, {Yi Hong} and Carlos Lam and Chen, {Ray Jade}",
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T1 - Maximum outer appendiceal diameter as a criterion of acute appendicitis

T2 - Evaluation at computerized tomography

AU - Chiu, Yu Hui

AU - Chen, Jen Dar

AU - Tiu, Chui Mei

AU - Chou, Yi Hong

AU - Lam, Carlos

AU - Chen, Ray Jade

PY - 2013

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N2 - Objective: The goal of this study was to assess the optimum diagnostic cutoff value of maximum outer appendiceal diameter on computed tomography (CT) images in patients with suspected acute appendicitis in the emergency department. Methods: A total of 328 patients with clinical suspicion of appendicitis were retrospectively reviewed. Evaluation of CT images, and chart review for clinical, laboratory, surgical, and pathologic findings were performed. Logistic regression was used to identify possible predictive factors influencing diagnosis of acute appendicitis. The receiver operating characteristic (ROC) curve was applied to determine the most suitable diagnostic cutoff value of appendiceal diameter for acute appendicitis. Results: In a total of 136 patients (41.5%) the diagnosis of acute appendicitis was made; 192 patients (58.5%) had nonacute appendicitis. Mean appendiceal diameter was 12.68±3.31mm in patients with acute appendicitis and 6.01±1.50mm in patients without. The appendiceal diameter had a significantly statistical difference to differentiate the presence from the absence of acute appendicitis with an area under the ROC curve of 0.985 (95% confidence interval, 0.973-0.996). An appendiceal diameter cutoff value of 8.15mm had a sensitivity of 97%, a specificity of 93.2%, and an accuracy of 94.8%. Appendiceal wall enhancement with intravenous contrast medium also had a significantly statistical difference for discriminating patients with acute appendicitis from those without by logistic regression. Conclusion: Detection of maximum outer appendiceal diameter and appendiceal wall enhancement with intravenous contrast medium on CT could help differentiate patients with acute appendicitis from those without. An appendiceal diameter greater than 8.15mm is particularly useful for diagnosis of acute appendicitis.

AB - Objective: The goal of this study was to assess the optimum diagnostic cutoff value of maximum outer appendiceal diameter on computed tomography (CT) images in patients with suspected acute appendicitis in the emergency department. Methods: A total of 328 patients with clinical suspicion of appendicitis were retrospectively reviewed. Evaluation of CT images, and chart review for clinical, laboratory, surgical, and pathologic findings were performed. Logistic regression was used to identify possible predictive factors influencing diagnosis of acute appendicitis. The receiver operating characteristic (ROC) curve was applied to determine the most suitable diagnostic cutoff value of appendiceal diameter for acute appendicitis. Results: In a total of 136 patients (41.5%) the diagnosis of acute appendicitis was made; 192 patients (58.5%) had nonacute appendicitis. Mean appendiceal diameter was 12.68±3.31mm in patients with acute appendicitis and 6.01±1.50mm in patients without. The appendiceal diameter had a significantly statistical difference to differentiate the presence from the absence of acute appendicitis with an area under the ROC curve of 0.985 (95% confidence interval, 0.973-0.996). An appendiceal diameter cutoff value of 8.15mm had a sensitivity of 97%, a specificity of 93.2%, and an accuracy of 94.8%. Appendiceal wall enhancement with intravenous contrast medium also had a significantly statistical difference for discriminating patients with acute appendicitis from those without by logistic regression. Conclusion: Detection of maximum outer appendiceal diameter and appendiceal wall enhancement with intravenous contrast medium on CT could help differentiate patients with acute appendicitis from those without. An appendiceal diameter greater than 8.15mm is particularly useful for diagnosis of acute appendicitis.

KW - Acute appendicitis

KW - Appendiceal diameter

KW - Appendiceal wall enhancement

KW - Computed tomography

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