Making the Diagnosis of Acute Appendicitis: Do More Preoperative CT Scans Mean Fewer Negative Appendectomies? A 10-Year Study
 (a–c) False-positive CT scans obtained with intravenous and oral contrast material in a 20-year-old woman with a 1-day history of abdominal pain that migrated to the right lower quadrant. The appendix (arrow) measures up to 10 mm in diameter, and periappendiceal fat stranding is present. The appendix appeared somewhat inflamed and enlarged at surgery, but no inflammation was noted at pathologic examination. An alternate cause of right lower quadrant pain was never established definitively. (Radiology 2010;254;2;460-468) © RSNA, 2010. All rights reserved. Printed with permission. |
Increased use of preoperative CT in patients with suspected appendicitis coincides with a dramatic decrease in negative appendectomies for younger women, a February Radiology study has found. Courtney A. Coursey, M.D., of the Department of Radiology at Duke University Medical Center in Durham, N.C., and colleagues, examined a surgical database of 925 patients who underwent urgent appendectomy between January 1998 and September 2007. In 2007, 93.2 percent of patients underwent preoperative CT, compared with 18.5 percent of patients in 1998.
Dr. Coursey and colleagues found that the negative appendectomy rate in women 45 years or younger decreased from 42.9 percent in 1998 to 7.1 percent in 2007, though they noted that the timing of the decline could not be proven to be associated with increased CT use.
For women over 45 years of age and for men regardless of age, there was no significant trend toward a lower negative appendectomy rate with increased use of CT. "The shift from single detector CT to multidetector CT and the use of decreasing slice thickness also correlated with a reduction in false positive diagnoses," researchers added.
Media Coverage of Radiology
In December 2009, media outlets carried 208 news stories generated by articles appearing in the print and online editions of Radiology. These stories reached an estimated 104 million people.
A news release was issued for a study about women at elevated risk for breast cancer who refuse breast MR imaging screening (Radiology 2010;254:79-87).
December coverage included America This Morning (ABC National TV), The Daily Buzz (Syndicated National TV), CBS Radio Network (National), Wall Street Journal This Morning (National Radio), WCBS-AM (New York), WCAU-TV (Philadelphia), KCBS-AM (San Francisco), WCCO-AM (Minneapolis), WWJ-AM (Detroit), WTOP-FM (Washington, D.C.), KIRO-FM (Seattle), WGRZ-TV (Buffalo), WNWO-TV (Toledo), WBAL-AM (Baltimore), KMOX-AM (St. Louis), Reuters, Gannett News Service, North American Press Syndicate, Healthday, MSN Health, Women's Health Weekly, Innovations Report, Health & Medicine Week, Cardiovascular Week, usnews.com, health.com, businessweek.com, foxnews.com, palmbeachpost.com, sciencedaily.com, medscape.com, modernmedicine.com and esciencenews.com.
February Public Information Activities to Focus on Heart Imaging
In February, RSNA's 60-Second Checkup program will focus on imaging of the heart, particularly cardiac CT.
