Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Added Value of Coronal Reformations for Duty Radiologists and for Referring Physicians or Surgeons in the CT Diagnosis of Acute Appendicitis

  • Lee, Kyoung-Ho (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center) ;
  • Kim, Young-Hoon (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center) ;
  • Hahn, Seo-Kyung (Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Lee, Kyung-Won (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center) ;
  • Lee, Hak-Jong (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center) ;
  • Kim, Tae-Jung (Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center) ;
  • Kang, Sung-Bum (Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Shin, Joong-Ho (Emergency Department, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Park, Byung-Joo (Medical Research Collaborating Center, Seoul National University Hospital, Seoul National University College of Medicine)
  • Published : 2006.06.30
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Abstract

Objective: To assess the added value of coronal reformation for radiologists and for referring physicians or surgeons in the CT diagnosis of acute appendicitis. Materials and Methods: Contrast-enhanced CT was performed using 16-detector-row scanners in 110 patients, 46 of whom had appendicitis. Transverse (5-mm thickness, 4-mm increment), coronal (5-mm thickness, 4-mm increment), and combined transverse and coronal sections were interpreted by four radiologists, two surgeons and two emergency physicians. The area under the receiver operating characteristic curve (Az value), sensitivity, specificity (McNemar test), diagnostic confidence and appendiceal visualization (Wilcoxon signed rank test) were compared. Results: For radiologists, the additional coronal sections tended to increase the Az value (0.972 vs. 0.986, p=0.076) and pooled sensitivity (92% [95% CI: 88, 96] vs. 96% [93, 99]), and enhanced appendiceal visualization in true-positive cases (p=0.031). For non-radiologists, no such enhancement was observed, and the confidence for excluding acute appendicitis declined (p = 0.013). Coronal sections alone were inferior to transverse sections for diagnostic confidence as well as appendiceal visualization for each reader group studied (p<0.05). Conclusion: The added value of coronal reformation is more apparent for radiologists compared to referring physicians or surgeons in the CT diagnosis of acute appendicitis.

Keywords

References

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