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首页> 外文期刊>AJR: American Journal of Roentgenology : Including Diagnostic Radiology, Radiation Oncology, Nuclear Medicine, Ultrasonography and Related Basic Sciences >Diagnosis of acute appendicitis with sliding slab ray-sum interpretation of low-dose unenhanced CT and standard-dose i.v. contrast-enhanced CT scans.
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Diagnosis of acute appendicitis with sliding slab ray-sum interpretation of low-dose unenhanced CT and standard-dose i.v. contrast-enhanced CT scans.

机译：小剂量未增强CT和标准剂量静脉内滑动平板射线求和解释对急性阑尾炎的诊断。对比增强的CT扫描。

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OBJECTIVE: The purpose of this study was to compare low-dose unenhanced CT with standard-dose i.v. contrast-enhanced CT in the diagnosis of appendicitis. MATERIALS AND METHODS: Two hundred seven adults with suspected appendicitis underwent CT with mean effective doses of both 4.2 and 8.0 mSv. Two radiologists retrospectively reviewed thin-section images by sliding a 5-mm-thick ray-sum slab. They rated the likelihood of appendicitis and appendiceal visualization on 5- and 3-point scales, respectively, and proposed alternative diagnoses. Likelihood > or = 3 was considered a positive diagnosis. Receiver operating characteristics analysis, the McNemar test, and the Wilcoxon's signed-rank test were used. RESULTS: Seventy-eight patients had appendicitis. The values of the area under the receiver operating characteristics curve were 0.98 for the low-dose unenhanced acquisition and 0.97 for the standard-dose contrast-enhanced acquisition for reader 1 (95% CI for the difference, -0.02 to 0.03) and 0.99 and 0.98 (-0.02 to 0.02) for reader 2. Sensitivity was 98.7% for low-dose unenhanced CT and 100% for standard-dose contrast-enhanced CT for reader 1 (p = 1.00) and 100% for both techniques for reader 2. Specificity was 95.3% and 93.0% (p = 0.25) and 96.9% and 96.9%. The interpretation was indeterminate (score 3) in 0.5% and 1.4% of cases for reader 1 (p = 0.63) and 0.5% and 0% for reader 2 (p = 1.00). A normal appendix was not visualized in 5.4% and 3.9% of cases by reader 1 (p = 0.63) and 3.9% and 2.3% of cases by reader 2 (p = 0.50). None of the patients whose appendix was not visualized had appendicitis. Diagnostic confidence, visualization score for a normal appendix, and correct alternative diagnosis tended to be compromised with use of low-dose unenhanced CT, showing a significant difference for a reader's confidence in the diagnosis of appendicitis (p = 0.004). The two techniques were comparable in the diagnosis of appendiceal perforation. CONCLUSION: Low-dose unenhanced CT is potentially useful in the diagnosis of appendicitis.
机译：目的：本研究的目的是将低剂量未增强CT与标准剂量静脉输注进行比较。对比增强CT诊断阑尾炎。材料与方法：207名怀疑患有阑尾炎的成人接受了CT检查，平均有效剂量分别为4.2和8.0 mSv。两名放射科医生通过滑动5毫米厚的射线求和平板回顾性地检查了薄层图像。他们分别在5点和3点量表上评估了阑尾炎和阑尾可视化的可能性，并提出了替代诊断方法。可能性>或= 3被认为是阳性诊断。使用接收器工作特性分析，McNemar测试和Wilcoxon的符号秩测试。结果：78例患者患有阑尾炎。对于阅读器1（低剂量未增强采集），接收器工作特性曲线下的面积值为0.98，对于标准剂量对比度增强采集，接收器工作特性曲线下的面积值为0.97（差异为95％CI，-0.02至0.03），以及0.99和读取器2的灵敏度为0.98（-0.02至0.02），低剂量未增强CT的灵敏度为98.7％，标准剂量对比增强CT的灵敏度为读取器1（p = 1.00），两种技术的灵敏度均为100％。特异性为95.3％和93.0％（p = 0.25）和96.9％和96.9％。对于阅读器1（p = 0.63）和阅读器2（p = 1.00）分别为0.5％和1.4％和0.5％和0％（3 =）的解释不确定。正常的阑尾在阅读器1的案例中占5.4％和3.9％（p = 0.63），在阅读器2的案例中分别占3.9％和2.3％（p = 0.50）。没有阑尾可视化的患者均没有阑尾炎。小剂量未增强CT的使用往往会损害诊断的置信度，正常阑尾的可视化评分以及正确的替代诊断，这表明读者对阑尾炎的置信度存在显着差异（p = 0.004）。两种技术在阑尾穿孔的诊断中具有可比性。结论：小剂量CT不增强可能对阑尾炎的诊断有帮助。

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