Gülten SABAN, Melda APAYDIN, Salih AKŞİT, Ebru KALKAN, Mehmet DİRİK

Kontrastsız spiral bilgisayarlı tomografinin (BT) akut apandisit tanısındaki yeri

Amaç: Akut apandisit şüphesi olan olgularda kontrastsiz spiral bilgisayarlı tomografi (BT) incelemesinin tamsal değerini araştırmaktır. Gereç ve yöntem: Bu çalışmada 8 aylık dönemde, acil servisten akut appandisit ön tanılı hastalarda, oral yada intravenöz (IV) kontrast madde verilmeden spiral BT tetkiki yapılmıştır. Hastaların 22'si, erkek 18'i kadındır.-. Hasta yaş grubu. 10-50 arasında değişmektedir. Her inceleme tek nefes alımında L3 vertebra düzeyinden simfisiz pubise kadar 5 mm kesit kalınlığı, 5 mm masa hareketi ile 3 mm rekonstrüksiyon indeksi kullanılarak yapılmıştır.Tranvers çapda 6 mm'yi gecen appandiks ve/veya eşliğinde periappendeküler inflamasyon çeküm duvar kalınlığında artış, appendikolit, laterokonal fasyada kalınlaşma bulguları appandisit kriteri olarak kabul edilmiştir. Kontrastsiz spiral tomografi bulguları, patoloji ve klinik takip sonucu elde edilen verilerle [karşılaştırılmıştır. Bulgular: Tüm yaş grupları birlikte incelendiğinde kontrastsiz spiral BT'nin akut appandisit tanısı koymada1 duyarlılığı %91, doğruluğu %90 olarak bulunmuştur.Erişkinlerde duyarlılık %96, doğruluk %93, çocuklarda ise duyarlılık %71, doğruluk %75 bulunmuştur. Erişkin ve çocuk yaş grubunda BT'nin doğruluk ve duyarlılık oranları arasında istatistiksel olarak anlamlı fark görülmüştür (p

Anahtar Kelimeler:

Tanı, Akut hastalık, Apandisit, Tomografi, Spiral Bilgisayarlı

Nonenhanced spiral computed tomography (CT) for the diagnosis of acute appendicitis

Objective: The purpose of this study was to determine the diagnostic accuracy of unenhanced spiral CT scans in patients with suspected acute appendicitis. : Material and method: In this study over a 8- month period, 40 patients whom were suspected for acute appendicitis were referred by the emergency department for CT scan, were imaged without IV nor oral contrast. Of these 40 patients, 22 were men and the rest 18 were women. The age of the patients were between 10 and 50. Each scan was obtained in a single breath -hold from the L3 vertebral body to pubic symphysis using 5-mm collimation, 5 mm table movement with 3. mm recontruction index. The primary CT criteria for diagnosing acute appendicitis were the identification of an appendix with a transverse diameter larger than 6 mm with inflammatory findings and also some other secondary findings were evaluated respectively. Final diagnosis was established by clinical follow - up and were compared with CT reports. Results: We found sensitivity of 91%, specificity of 90% regarding all age groups. In adult patients, the sensitivity; was %96, and specificity %93. In children, the sensitivity and specificity were found respectively; 71% and 75% (p<0.Q5).Conclusion: Unenhanced spiral CT is an accurate, effective technique for diagnosing acute appendicitis. The contrast material need to be used only for the children because of the low effectiviness of unenhanced spiral technique in this group.

Keywords:

Diagnosis, Acute Disease, Appendicitis, Tomography, Spiral Computed,

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