Assessment of ultrasonography and computed tomography in the diagnostic strategy of suspected appendicitis

Abstract

In this thesis the assessment of ultrasonography (US) and Computed Tomography (CT) in the diagnostic strategy of suspected appendicitis is presented. The first study showed that focused single-detector helical CT as well as graded compression US performed in a general community teaching hospital by both body imaging radiologists and general radiology staff members have a similar accuracy for the diagnosis of acute appendicitis. A second study showed that in interpreting CT images the expertise of the attending radiologist should be considered. A third study showed that gender seems to affect the accuracy of US and CT in patients suspected of acute appendicitis. A fourth study showed that US as a sole imaging tool is of limited value both in women with unequivocal and in women with equivocal signs of appendicitis. A fifth study showed that US and CT implemented in a diagnostic pathway yields a high diagnostic accuracy for acute appendicitis without adverse events due to delay in treatment. A sixth study showed that for a majority of the surgeons, the diagnosis of acute appendicitis is based on clinical signs and symptoms. US and CT can be valuable in diagnosing appendicitis but further cooperation between surgeons and radiologists is required.