Publication: Akut apandisit olgularında kontrastsız helikal BT’nin tanı değeri
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Date
2003-01-01
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Abstract
Amaç: Akut apandisit olgularında kontrastsız helikal BT'nin tanısal etkinliğini belirlemek. Gereç ve Yöntem: Acil servis tarafından akut apandisit ön tanısıyla servisimize gönderilen toplam 22 olguya helikal BT incelemesi yapıldı. Tarama alanı T12 vertebra korpusu düzeyi ile simfiz pubis arası ve kesit kalınlığı 5 mm olarak belirlendi. İnceleme sırasında oral ya da intravenöz kontrast madde kullanılmadı. Apendeks çapının 6 mm ve üzerinde olması ile apendeks lojunda yumuşak doku dansitesinde kitle varlığı, akut apandisit açısından pozitif bulgular olarak kabul edildi. İki ayrı radyolog tarafından değerlendirilen filmler cerrahi girişim veya 15 günlük klinik takip sonuçları ile karşılaştırıldı. Bulgular: Cerrahi girişim ve klinik takipler sonucunda 12 olguda akut apandisit saptandı. BT ile 1 hastada yanlış pozitif sonuç alındı. Elde edilen verilerin değerlendirilmesinde helikal BT'nin akut apandisit tanısında duyarlılığı % 100, özgüllüğü % 91, pozitif öngörü değeri % 92, negatif öngörü değeri % 100, doğruluk oranı % 96 olarak saptandı. Sonuç: Kontrastsız helikal BT incelemesi akut apandisit şüphesi olan olguların değerlendirilmesinde güvenilir bir yöntemdir.
Purpose: To determine the value of non-contrast helical CT in the evaluation of patients with suspected acute appendicitis. Material and Method: Helical CT was performed in 22 cases with suspected acute appendicitis referred by the emergency service. Scanning area was between T12 vertebra corpus and symphisis pubis, and 5 mm collimation was used. No oral or intravenous contrast media was used. Findings that correlated with acute appendicitis were determined as appendix lumen diameter greater than or equal to 6 mm and mass lesion with soft tissue density in the appendix area. The examinations were separately assessed by two radiologists and correlation was made with surgical and clinical follow-up findings. Results: 12 cases were diagnosed to have acute appendicitis with surgical and clinical follow-up findings. One patient was false positively diagnosed as acute appendicitis with helical CT. Helical CT was found to have a sensitivity of 100%, specificity of 91%, positive predictive value of 92%, negative predictive value of 100%, and overall accuracy of 96% in the diagnosis of acute appendicitis. Conclusion: Unenhanced helical CT examination is an effective method in the evaluation of patients with suspected acute appendicitis.
Purpose: To determine the value of non-contrast helical CT in the evaluation of patients with suspected acute appendicitis. Material and Method: Helical CT was performed in 22 cases with suspected acute appendicitis referred by the emergency service. Scanning area was between T12 vertebra corpus and symphisis pubis, and 5 mm collimation was used. No oral or intravenous contrast media was used. Findings that correlated with acute appendicitis were determined as appendix lumen diameter greater than or equal to 6 mm and mass lesion with soft tissue density in the appendix area. The examinations were separately assessed by two radiologists and correlation was made with surgical and clinical follow-up findings. Results: 12 cases were diagnosed to have acute appendicitis with surgical and clinical follow-up findings. One patient was false positively diagnosed as acute appendicitis with helical CT. Helical CT was found to have a sensitivity of 100%, specificity of 91%, positive predictive value of 92%, negative predictive value of 100%, and overall accuracy of 96% in the diagnosis of acute appendicitis. Conclusion: Unenhanced helical CT examination is an effective method in the evaluation of patients with suspected acute appendicitis.
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Keywords
Appendicitis Tomography, Spiral Computed, Tomografi, Spiral Bilgisayarlı, Apandisit
Citation
TÜNEY D., SUNGURLU F., TÜRK A., CİMŞİT Ç., YILDIZ M. E. , SEMİZ A., EKİNCİ G., "Akut apandisit olgularında kontrastsız helikal BT’nin tanı değeri", Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Tıp Dergisi, cilt.43, sa.1, ss.24-27, 2003