USING UNENHANCED HELICAL CT WITH ENTERIC CONTRAST MATERIAL FOR SUSPECTED APPENDICITIS IN PATIENTS TREATED AT A COMMUNITY-HOSPITAL

OBJECTIVE. We evaluated the accuracy of unenhanced helical CT with ent eric contrast material in the diagnosis of appendicitis in children an d adults treated at a community hospital. SUBJECTS AND METHODS. Over a n 8-month period, 100 consecutive patients with right lower quadrant p ain and suspected appendicitis were prospectively evaluated. Thin-coll imation helical CT scanning was performed after administration of ente ric contrast material. CT interpretations were correlated with surgica l pathology (45 patients) and clinical followup (55 patients). RESULTS . The findings of 33 CT scans were interpreted as positive for appendi citis (29 true-positives and four false-positives), and the findings o f 67 were interpreted as negative for appendicitis (66 true-negatives and one false-negative). Sensitivity was 97%, specificity was 94%, acc uracy was 95%, positive predictive value was 88%, and negative predict ive value was 99%. In the 67 CT scans with negative findings for appen dicitis, an alternative diagnosis was made for 36 patients (54%). CONC LUSION. Unenhanced helical CT with enteric contrast material for the e valuation of appendicitis can be implemented in a community hospital. In our study, such imaging achieved excellent accuracy.