Diagnosis of Acute Appendicitis with MSCT Plain Scan

Purpose:To investigate the features of acute appendicitis on MSCT plain scan and evaluate the value of the preoperative diagnosis by MSCT.Methods:One hundred and seven cases of pathologically proven acute appendicitis were included in the study,aged 15 to 94 years,median 46.6 years,male 66 cases,female 41 cases.GE Lightspeed Plus 16 multi-slice spiral CT was used for scanning with slice thickness 1.25mm and reconstruction.Two experienced radiologists retrospectively analyzed together and compared the result with the preoperative diagnosis.Results: CT features of acute appendicitis were as follows:enlarged appendix(100,93.46%,diameter 6-22mm);appendix bezoar(40,37.38%);appendix pneumatosis(15,15.89%);stripe shadow around appendix(59,71.03%);ileocecal lymph node hyperplasia(63,58.88%);the right lower quadrant bowel reflex enterectasis(49,45.74%).Simple appendicitis was verified in 19 cases,preoperative diagnostic accuracy was 68.42%(13/19),the average diameter of the appendix was 8.6±2.3mm,most cases were without exudation around the appendix(17/19);suppurative appendicitis was verified in 63 cases,preoperative diagnostic accuracy was 63.49%(40/63),appendix diameter was 12.9±3.9mm,obvious exudation around the appendix was shown;gangrenous appendicitis was verified in 21 patients,preoperative diagnostic accuracy was 80.95%(40/63),uneven thickness with average diameter of 19.2 ± 8.0mm and significant exudation around the appendix,appendix pneumatosis and bezoar were common.There were significant differences in the diameter of the appendix(P0.01).Appendiceal abscess with fluid region in 4 cases were correct diagnosed.Appendix pneumatosis and bezoar in the 4 types were with significant differences(P0.01),whereas exudation in simple appendicitis was less than the other 3 types(P0.01).Conclusion: Acute appendicitis has a high diagnostic accuracy when using MSCT plain scan which can be useful for preoperative typing and assessment.