Assessing the Impact of the Amount of Contrast Material used in Abdominal CT Examinations for the Diagnosis of Appendicolith

Abstract

Aim: The aim of the present study was to investigate the impact of the amount of contrast material used in abdominal CT examinations regarding the diagnosis of appendicolith.

Methods: This was a cross-sectional study that was performed in the Department of Radiology to evaluate the diagnostic value of the CT examination in patients with acute appendicitis. One hundred patients that met the inclusion criteria entered the study using census method. Demographic data of patients including age, gender were obtained.

Results: In 70 cases, CT scans indicated acute appendicitis, and post-appendectomy pathology supported the diagnosis. CT scan patients had 5 false positives and 8 false negatives. Patients exhibited retrocecal appendixes and decreased peritoneal fat on CT scans. CT scans with minimal clinical suspicion had 88.6% sensitivity, 82.8% specificity, 95.5% positive predictive value, and 78.2% negative predictive value based on pathology findings. We analyzed CT and ultrasonography by patient gender.

Conclusion: If acute appendicitis, nephrolithiasis, or ureterolithiasis is suspected, this research advises an abdominal CT using the following methodology. The CT treatment should begin with a low-dose pelvic CT scan of the cecum without contrast. Next, have a second CT scan with oral and IV contrast.

Keywords: Acute appendicitis; Appendicoliths; Nephrolithiasis; Computed Tomography (CT); Contrast material