Contrast-enhanced multidetector-row computed tomography can predict pathological findings of acute appendicitis in children

被引:2
作者
Hashizume, Naoki [1 ,4 ]
Iinuma, Yasushi [1 ]
Hirayama, Yutaka [1 ]
Nitta, Kohju [1 ]
Iida, Hisataka [1 ]
Shiotani, Motoi [2 ]
Shibuya, Hiroyuki [3 ]
Yagi, Minoru [4 ]
机构
[1] Niigata City Gen Hosp, Dept Pediat Surg, Niigata, Japan
[2] Niigata City Gen Hosp, Dept Radiol, Niigata, Japan
[3] Niigata City Gen Hosp, Dept Pathol, Niigata, Japan
[4] Kurume Univ, Sch Med, Dept Pediat Surg, Kurume, Fukuoka 830, Japan
来源
ACUTE MEDICINE & SURGERY | 2016年 / 3卷 / 01期
关键词
Acute appendicitis; multidetector-row CT; pathology; pediatrics; radiology;
D O I
10.1002/ams2.131
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims: To retrospectively evaluate the correlation between multidetector-row computed tomography findings of acute appendicitis and the pathological status of acute appendicitis, and evaluate the capability of multidetector-row computed tomography to predict the pathological status of acute appendicitis in children. Methods: The presence of a distended appendix (> 6 mm in transverse diameter) was used as a primary sign to indicate the presence of appendiceal inflammation. The presence of appendiceal wall thickening (> 1 mm) and enhanced appendiceal wall continuity were also used as predictive findings to reflect the degree of progression of acute appendicitis on multidetector-row computed tomography findings. The findings of each individual case were classified into four grades. The final pathological diagnosis was classified into four groups: normal findings, only mucosal inflammation, inflammation with intramural spreading, and gangrenous. The relationship between the pathological grades and computed tomography grades was analyzed using Spearman's rank correlation test. Results: Four of six cases in Grade 0 reflected normal appendiceal findings (66.7%) and 3 of 5 cases in Grade I reflected only mucosal inflammation status (60.0%). Forty-four of 51 cases in Grade II reflected intramural inflammation status (86.3%), and 40 of 57 cases in Grade III reflected gangrenous status (70.2%). The multidetector-row computed tomography grade was significantly correlated to the pathological grade with Spearman's rank correlation coefficient of 0.689 (P < 0.001). Conclusions: There was a close relationship between the multidetector-row computed tomography imaging findings and the pathological findings. This preoperative information is extremely useful for decision-making in the treatment strategy for acute appendicitis in children.
引用
收藏
页码:21 / 25
页数:5
相关论文
共 21 条
  • [1] CT and appendicitis: evaluation of correlation between CT diagnosis and pathological diagnosis
    Andre, J. B.
    Sebastian, V. A.
    Ruchman, R. M.
    Saad, S. A.
    [J]. POSTGRADUATE MEDICAL JOURNAL, 2008, 84 (992) : 321 - 324
  • [2] Pediatric CT research elevates public health concerns: Low-dose radiation issues are highly politicized
    Bertell, Rosalie
    Ehrle, Lynn Howard
    Schmitz-Feuerhake, Inge
    [J]. INTERNATIONAL JOURNAL OF HEALTH SERVICES, 2007, 37 (03): : 419 - 439
  • [3] Perforated versus nonperforated acute appendicitis: Accuracy of multidetector CT detection
    Bixby, Sarah D.
    Lucey, Brian C.
    Soto, Jorge A.
    Theyson, Jens M.
    Ozonoff, Al
    Varghese, Jose C.
    [J]. RADIOLOGY, 2006, 241 (03) : 780 - 786
  • [4] Estimated risks of radiation-induced fatal cancer from pediatric CT
    Brenner, DJ
    Elliston, CD
    Hall, EJ
    Berdon, WE
    [J]. AMERICAN JOURNAL OF ROENTGENOLOGY, 2001, 176 (02) : 289 - 296
  • [5] Chalazonitis AN, 2008, DIAGN INTERV RADIOL, V14, P19
  • [6] The most useful findings for diagnosing acute appendicitis on contrast-enhanced helical CT
    Choi, D
    Park, H
    Lee, YR
    Kook, SH
    Kim, SK
    Kwag, HJ
    Chung, EC
    [J]. ACTA RADIOLOGICA, 2003, 44 (06) : 574 - 582
  • [7] Histologic severity of appendicitis can be predicted by computed tomography
    Hansen, AJ
    Young, SW
    De Petris, G
    Tessier, DJ
    Hernandez, JL
    Johnson, DJ
    [J]. ARCHIVES OF SURGERY, 2004, 139 (12) : 1304 - 1308
  • [8] Independent predictors of acute appendicitis on CT with pathologic correlation
    Ives, Elizabeth P.
    Sung, Susan
    McCue, Peter
    Durrani, Haroon
    Halpern, Ethan J.
    [J]. ACADEMIC RADIOLOGY, 2008, 15 (08) : 996 - 1003
  • [9] Ultrasound-based decision making in the treatment of acute appendicitis in children
    Kaneko, K
    Tsuda, M
    [J]. JOURNAL OF PEDIATRIC SURGERY, 2004, 39 (09) : 1316 - 1320
  • [10] Acute appendicitis in children: comparison of clinical diagnosis with ultrasound and CT imaging
    Karakas, SP
    Guelfguat, M
    Leonidas, JC
    Springer, S
    Singh, SP
    [J]. PEDIATRIC RADIOLOGY, 2000, 30 (02) : 94 - 98