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Erschienen in: Emergency Radiology 6/2017

01.12.2017 | Original Article

Abdominal-pelvic scanning parameters revisited: a case for Z-axis reduction in patients with clinical suspicion for acute appendicitis

verfasst von: Darshan C. Patel, Yu-hui Huang, Jonathan Meyer, Amir Sepahdari

Erschienen in: Emergency Radiology | Ausgabe 6/2017

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Abstract

Purpose

The purpose of this study was to determine if CT for appendicitis can be abbreviated to begin at the top of the L2 vertebral body level and still maintain the detection rate of appendicitis and other symptomatic pathology without omitting significant incidental findings.

Methods

Retrospective review of CT abdomen-pelvis exams for suspected appendicitis over a 5-month period was performed. The Z-axis scan length of the original full scans and theoretical limited scans from the top of L2 were recorded and calculated. Images were reviewed for incidental findings above the L2 vertebral body level and categorized by severity per American College of Radiology (ACR) white paper guidelines. Final diagnoses based on imaging findings were also recorded.

Results

One hundred nineteen patients (46 males, 73 females, mean age 29 ± 14) were included. Appendicitis was present in 26 cases (22%). Using a theoretical scan beginning at the top of the L2 vertebral body, none of the findings leading to diagnosis of appendicitis would have been missed. A total of 30 incidental findings were found above the L2 vertebral body. Per ACR white paper guidelines, 26 of these findings did not require additional imaging follow-up. Additional follow-up imaging was recommended for 3 of the findings above L2, and 1 right adrenal metastasis was found above L2 in a patient with previously undiagnosed NSCLC. This patient coincidentally also had appendicitis. No symptomatic pathology would have been missed had the scans begun at the top of the L2 vertebral body. Such an abbreviated scan would have resulted in a mean Z-axis reduction of 12.9 cm (30.3%).

Conclusions

CT using abbreviated Z-axis scan length can reduce radiation dose and provide necessary imaging needed to diagnose appendicitis or other symptomatic pathology without omitting significant incidental findings.
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Metadaten
Titel
Abdominal-pelvic scanning parameters revisited: a case for Z-axis reduction in patients with clinical suspicion for acute appendicitis
verfasst von
Darshan C. Patel
Yu-hui Huang
Jonathan Meyer
Amir Sepahdari
Publikationsdatum
01.12.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Emergency Radiology / Ausgabe 6/2017
Print ISSN: 1070-3004
Elektronische ISSN: 1438-1435
DOI
https://doi.org/10.1007/s10140-017-1539-x

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