THE ACCURACY OF THE LOW DOSE NATIVE COMPUTED TOMOGRAPHY PROTOCOL IN PATIENTS WITH SUSPECTED ACUTE APPENDICITIS

Volume 14 , Issue 4 , December 2024 , Pages 349-358

Authors

Hezha Abdulla Mohammed Mohemmed 1 ; Naser Abdalla Mohammed Mohammed 2

1 Department of Radiology and Medical Imaging Sulaymaniyah Teaching Hospital, Kurdistan Region, Iraq.

2 Faculty of Medicine - University of Sulaimani, Kurdistan Region, Iraq.

DOI logo 10.17656/jsmc.10482

Keywords

Abstract

Background
To determine the accuracy of native computed tomography (CT) without the oral, intravenous, or rectal
administration of contrast material in confirming suspected acute appendicitis.
Objectives
the prospective study conducted within six months in Shar hospital in cases were admitted with the abdominal pain and suspicion of acute appendicitis, and determination of the acute appendicitis diagnosed by clinical manifestations, ultrasound to exclude other possible right iliac fossa pain and then native low dose CT scan of the pelvic was done to diagnose acute appendicitis and determine the accuracy of the method by comparing the results to the histopathological examinations postoperatively.
Materials and Methods
low dose native CT scan and abdominal USG were performed for each patient presented with acute symptoms. CT examination for acute abdominal pain were performed without using intravenous contrast media, no oral nor rectal contrast were used. Examinations were performed on the GE the Optima CT660 enables 128 slices per rotation. Patients were between age of 18-45yrs of age with the clinical suspicion of acute appendicitis with the exclusion criteria includes patients with the prior history of appendectomy, female patients with pregnancy test positive , also patients with gynecological problem like ectopic pregnancy, ovarian cysts ,and patients with other gastrointestinal problem like diverticulitis, inflammatory bowel disease, and cancer patients were excluded in the total of 100 patients assessed, and the clinical manifestations, laboratory findings, imaging findings, operation records and pathological findings were analyzed.
Results
There were 88 cases true-positive diagnoses, 7cases were have alternative diagnosis which were excluded by the native CT scan, two false-negative diagnoses, and two false-positive diagnoses, which yielded a sensitivity of 97.8%, a specificity of 77.8%, and an accuracy of 96%.
Conclusion
Non-enhanced helical CT is a highly accurate technique for diagnosing or excluding acute appendicitis. Developing experience with the technique and understanding the subtleties of interpretation can further improve diagnostic accuracy.

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  • First online29 April 2025
  • Published at21 December 2024

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