Role of focused appendiceal computed tomography in clinically equivocal acute appendicitis.

OBJECTIVE

To determine the accuracy of FACT (focused appendiceal computed tomography) in evaluation of acute appendicitis.

METHODS

The study was conducted in Aga Khan University Hospital, Karachi, over a period of one year. Sixty-three patients with clinically equivocal acute appendicitis underwent thin-section non-enhanced helical CT. Axial scans were obtained in a single breath hold from L2 vertebral level to the pubic symphysis with 5-mm collimation and a pitch of 1.5. All scans were obtained without oral, intravenous, or rectal contrast material. Criteria for diagnosis of acute appendicitis included an enlarged appendix (>6 mm diameter) and periappendiceal inflammation. Final diagnoses were established with the results of surgical or clinical follow-up.

RESULTS

There were 21 true-positive diagnoses, 38 true-negative diagnoses, no false-positive diagnoses, and 2 false-negative diagnoses, which yielded a sensitivity of 91% and a specificity of 100%.

CONCLUSION

Non-enhanced FACT is a highly accurate problem solving technique in clinically equivocal cases of acute appendicitis.