Pitfalls and mimickers at 64-section helical CT that cause negative appendectomy: an analysis from 1057 appendectomies

被引:20
作者
Soyer, Philippe [1 ,2 ,3 ]
Dohan, Anthony [1 ,2 ,3 ]
Eveno, Clarisse [2 ,3 ,4 ]
Naneix, Anne-Laure [2 ,5 ]
Pocard, Marc [2 ,3 ,4 ]
Pautrat, Karine [4 ]
Hamzi, Lounis [1 ]
Duteil, Christelle [6 ,7 ]
Lavergne-Slove, Anne [2 ,5 ]
Boudiaf, Mourad [1 ]
机构
[1] Hop Lariboisiere, AP HP, Dept Abdominal Imaging, F-75475 Paris 10, France
[2] Univ Paris Diderot, Sorbonne Paris Cite, F-75010 Paris, France
[3] INSERM, U965, F-75475 Paris 10, France
[4] Hop Lariboisiere, AP HP, Surg Oncol & Digest Unit, F-75475 Paris 10, France
[5] Hop Lariboisiere, AP HP, Dept Pathol, F-75475 Paris 10, France
[6] Hop Lariboisiere, AP HP, Dept Publ Hlth, F-75475 Paris 10, France
[7] Hop Lariboisiere, AP HP, Hlth Econ Dept, F-75475 Paris 10, France
关键词
Acute appendicitis; Helical CT; Computed tomography; Appendix; CT; SUSPECTED ACUTE APPENDICITIS; COMPUTED-TOMOGRAPHY; PERFORATION RATES; DIAGNOSIS; IMPACT; THICKNESS; VISUALIZATION; ACCURACY; 10-YEAR; SIGNS;
D O I
10.1016/j.clinimag.2013.05.006
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: To determine the rate of negative appendectomy and clarify the causes of negative appendectomy in patients with clinically suspected acute appendicitis who had surgery after 64-section helical computed tomography (CT). Material and Methods: A retrospective analysis of 1057 patients who had appendectomy after 64-section helical CT was performed to determine the rate of negative appendectomy. The 64-section helical CT examinations obtained with submillimeter and isotropic voxels in the patients with negative appendectomy were analyzed by two readers and compared to clinical, operative and histopathological reports, discharge summaries and original radiology reports. Results: The negative appendectomy rate was 1.7% (18/1057). Appendix enlargement (>6 mm) and fat stranding were present in 17 (17/18; 94%) and 6 patients (6/18; 33%), respectively. In 13 patients (13/18; 72%) 64-section helical CT findings were consistent with acute appendicitis. Interpretive errors in original imaging reports were identified in five patients (5/18; 28%). Conclusion: The preoperative use of 64-section helical CT results in a very low rate of negative appendectomy. Patients with negative appendectomy have 64-section helical CT findings consistent with a diagnosis of acute appendicitis in the majority of cases. Interpretive errors are less frequent. (C) 2013 Elsevier Inc. All rights reserved.
引用
收藏
页码:895 / 901
页数:7
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