The value of unenhanced CT in the diagnosis of acute appendicitis

OBJECTIVE: To establish the accuracy of unenhanced CT in the preoperative diagnosis of acute appendicitis. DESIGN: Accuracy study, prospective and blinded. SETTING: The University Hospital. PARTICIPANTS: 52 patients with clinical and laboratorial manifestations of acute appendicitis. CT diagnosis was made by: presence of an abnormal appendix, appendiceal calculi with pericecal phlegmon or alterations in the pericecal appendicular site and absence of signs that may lead to other diagnosis. MAIN OUTCOME MEASURES: Overall accuracy, comparing the tomographic aspects with the intra-operative findings and pathological reports ("gold standard"). RESULTS: Acute appendicitis was confirmed in 44 cases. Efficacy was 92%, sensitivity was 91%, specificity was 100%, positive predictive value was 100% and negative predictive value was 67%. CONCLUSIONS: Unenhanced CT presents a similar overall accuracy to that reported by other authors who studied enhanced CT diagnosis of acute appendicitis