Wazzan Mohammad, Abduljabbar Ahmed, Khizindar Huda, Alzahrani Aghnar, Aljohani Renad M, Nahas Rana, Aman Rahf, Tawfiq Shouq, Aldajani Arwa
Department of Radiology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU.
Department of Medicine and Surgery, Albaha University, Baha, SAU.
Cureus. 2023 Nov 2;15(11):e48154. doi: 10.7759/cureus.48154. eCollection 2023 Nov.
Acute appendicitis is a prevalent condition that requires accurate and timely diagnosis and management to avoid potential complications. Classically, the diagnosis of appendicitis is made using the appendicular outer-to-outer wall diameter. In this study, we examined the sensitivity and specificity of computed tomography (CT) scans for diagnosing acute appendicitis using wall thickness and lumen thickness rather than diameter. This study included data from 350 patients who presented to the emergency department with clinically suspected acute appendicitis. All patients underwent a CT scan, and 62 radiologically positive patients underwent surgery. A radiological diagnosis was made using the conventional outer-to-outer wall diameter with a cut-off of 6 mm for a positive diagnosis. These 62 positive CT scans were reviewed and compared with surgical results. The study showed that a threshold of 2.25 mm for appendicular lumen thickness is an excellent diagnostic tool for acute appendicitis, demonstrating a high sensitivity of 96.4% and a lower specificity of 67%. In contrast, 1.6 mm wall thickness indicates acute appendicitis, with 81.8% sensitivity and 84% specificity. However, the wall thickness remains inferior to the conventionally used measurement of 6.75 mm for appendicular diameter, with a sensitivity of 87.5% and a specificity of 100%.
急性阑尾炎是一种常见病症，需要准确及时的诊断和治疗以避免潜在并发症。传统上，阑尾炎的诊断是通过阑尾外壁到外壁的直径来进行的。在本研究中，我们使用壁厚和管腔厚度而非直径来检验计算机断层扫描（CT）对诊断急性阑尾炎的敏感性和特异性。本研究纳入了350例因临床怀疑急性阑尾炎而就诊于急诊科的患者的数据。所有患者均接受了CT扫描，62例放射学检查呈阳性的患者接受了手术。使用传统的外壁到外壁直径进行放射学诊断，阳性诊断的截断值为6毫米。对这62例阳性CT扫描结果进行了复查并与手术结果进行了比较。研究表明，阑尾管腔厚度阈值为2.25毫米是诊断急性阑尾炎的一种优秀诊断工具，敏感性高达96.4%，特异性较低，为67%。相比之下，壁厚1.6毫米提示急性阑尾炎，敏感性为81.8%，特异性为84%。然而，壁厚在诊断急性阑尾炎方面仍不如传统使用的阑尾直径测量值6.75毫米，其敏感性为87.5%，特异性为100%。
