Peck J, Peck A, Peck C, Peck J
Departments of Surgery and Emergency Medicine, Tuality Community Hospital, Hillsboro, Oregon, USA.
Am J Surg. 2000 Aug;180(2):133-6. doi: 10.1016/s0002-9610(00)00435-9.
The accuracy of noncontrast helical computed tomography (CT) for appendicitis has recently been demonstrated. What is its clinical utility?
This was a retrospective review of 443 consecutive community hospital patients evaluated for acute appendicitis over an 18-month period using limited pelvic CT scan or clinical acumen alone.
Appendicitis was pathologically proven in 158 patients. The negative appendectomy rate was 5.4%. The best radiological indicators for a positive CT for appendicitis were pericecal inflammation (88%) and appendicolith(57%). Appendiceal CT was found to have a 92% sensitivity, 99.6% specificity, and a 97.5% accuracy. There were 260 patients who had a negative CT; 243 of these were sent home. Alternative diagnoses were identified in 22% of patients.
The liberal use of noncontrast helical CT results in a low negative appendectomy rate and a high degree of confidence that a negative CT will allow patients to be sent home safely.
近期已证实非增强螺旋计算机断层扫描（CT）诊断阑尾炎的准确性。其临床实用性如何？
这是一项对443例连续的社区医院患者进行的回顾性研究，这些患者在18个月期间仅通过有限的盆腔CT扫描或临床敏锐度评估急性阑尾炎。
158例患者经病理证实为阑尾炎。阴性阑尾切除率为5.4%。CT诊断阑尾炎阳性的最佳影像学指标是盲肠周围炎症（88%）和阑尾结石（57%）。阑尾CT的敏感性为92%，特异性为99.6%，准确性为97.5%。有260例患者CT检查结果为阴性；其中243例被送回家。22%的患者被确诊为其他疾病。
广泛使用非增强螺旋CT可降低阴性阑尾切除率，并高度确信CT检查结果为阴性的患者可以安全回家。
