Kılınçer Abidin, Akpınar Erhan, Erbil Bülent, Ünal Emre, Karaosmanoğlu Ali Devrim, Kaynaroğlu Volkan, Akata Deniz, Özmen Mustafa
Department of Radiology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara, 06100, Turkey.
Department of Emergency Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Eur Radiol. 2017 Aug;27(8):3317-3325. doi: 10.1007/s00330-016-4728-1. Epub 2017 Jan 23.
To determine the diagnostic accuracy of abdominal CT with compression to the right lower quadrant (RLQ) in adults with acute appendicitis.
168 patients (age range, 18-78 years) were included who underwent contrast-enhanced CT for suspected appendicitis performed either using compression to the RLQ (n = 71) or a standard protocol (n = 97). Outer diameter of the appendix, appendiceal wall thickening, luminal content and associated findings were evaluated in each patient. Kruskal-Wallis, Fisher's and Pearson's chi-squared tests were used for statistical analysis.
There was no significant difference in the mean outer diameter (MOD) between compression CT scans (10.6 ± 1.9 mm) and standard protocol (11.2 ± 2.3 mm) in patients with acute appendicitis (P = 1). MOD was significantly lower in the compression group (5.2 ± 0.8 mm) compared to the standard protocol (6.5 ± 1.1 mm) (P < 0.01) in patients without appendicitis. A cut-off value of 6.75 mm for the outer diameter of the appendix was found to be 100% sensitive in the diagnosis of acute appendicitis for both groups. The specificity was higher for compression CT technique (67.7 vs. 94.9%).
Normal appendix diameter was significantly smaller in the compression-CT group compared to standard-CT group, increasing diagnostic accuracy of abdominal compression CT.
• Normal appendix diameter is significantly smaller in compression CT. • Compression could force contrast material to flow through the appendiceal lumen. • Compression CT may be a CT counterpart of graded compression US.
确定对右下象限（RLQ）进行压迫的腹部CT对成人急性阑尾炎的诊断准确性。
纳入168例患者（年龄范围18 - 78岁），这些患者因疑似阑尾炎接受了增强CT检查，其中对RLQ进行压迫的有71例，采用标准方案的有97例。评估每位患者阑尾的外径、阑尾壁增厚情况、管腔内容物及相关表现。采用Kruskal - Wallis检验、Fisher检验和Pearson卡方检验进行统计学分析。
急性阑尾炎患者中，压迫CT扫描组（10.6±1.9mm）与标准方案组（11.2±2.3mm）的平均外径（MOD）无显著差异（P = 1）。在无阑尾炎的患者中，压迫组的MOD（5.2±0.8mm）显著低于标准方案组（6.5±1.1mm）（P < 0.01）。阑尾外径的截断值为6.75mm时，两组对急性阑尾炎的诊断敏感性均为100%。压迫CT技术的特异性更高（67.7%对94.9%）。
与标准CT组相比，压迫CT组中正常阑尾直径明显更小，提高了腹部压迫CT的诊断准确性。
• 压迫CT中正常阑尾直径明显更小。• 压迫可促使对比剂流经阑尾管腔。• 压迫CT可能是分级压迫超声的CT对应方法。
