The role of 256-slice CT in differentiation between non-perforated and perforated appendicitis

Objective: The objective of the present study was to analyze the efficacy of 256-slice CT in differentiation between the perforated and non-perforated appendicitis. Subjects and methods: The study included 85 patients with acute appendicitis. Appendicectomy and pathological confirmation were done for 79 patients and classified into 44 patients with non-perforated appendix and other 35 patients with perforated appendix. The statistical analysis was performed using six CT findings (abscess formation, phlegmon, extraluminal air, extraluminal appendicolith, focal defect in the appendicular wall and inflammatory changes of the retroperitoneal space) individually and when combined together in five groups. Results: The sensitivity, specificity and accuracy of each CT finding were ranged between 20%–51%, 86–100% and 65–76% respectively. The PPV and NPV of these findings ranged between 75–100% and 61–70% respectively. Detection of any of these findings in combination of different groups resulted in raising of the sensitivity reaching between 71 and 97%. Conclusion: Multislice CT is considered the modality of choice for imaging of acute appendicitis, not only to confirm the diagnosis but also it plays an important role in assessment of appendicular complication, particularly in detection of perforated appendix.