Evaluation of suspected appendicitis in children and young adults: HelicalCT

PURPOSE: To evaluate the accuracy of helical computed tomography (CT) for t he diagnosis of appendicitis in children and to assess the utility of CT in establishing alternative diagnoses. MATERIALS AND METHODS: The medical records of 154 children (median age, 12 years; age range, 1-20 years) who were suspected to have appendicitis and w ho underwent CT were reviewed. The gastrointestinal tract was opacified in 151 of 154 patients: Only orally administered contrast material was used in 126 patients; only rectally administered contrast material, in 21 patients ; and both oral and rectal contrast material, in four patients. CT findings were correlated with surgical and histopathologic findings or with clinica l follow-up findings. RESULTS: Sixty-four CT scans were interpreted as positive for appendicitis and included 58 true-positive and six false-positive scans. Ninety scans we re interpreted as negative and included 87 true-negative and three false-ne gative scans. CT had a sensitivity 95% and a specificity of 94% for the dia gnosis of appendicitis. In addition, In 32 (34%) of 93 patients without app endicitis, an alternative diagnosis was established on the basis of CT find ings. CONCLUSION: Helical CT is useful in a pediatric population to diagnose or e xclude appendicitis and to establish an alternative diagnosis.