Objective: The aim of this prospective observational study was to compare the diagnostic accuracy and efficacy of emergency non-contrast CT abdomen screening and ultrasonography in the evaluation of acute appendicitis among patients visiting the Emergency Room (ER) of Saveetha Medical College, Chennai, over a two-year period from January 2020 to January 2022.
Methods: A total of 500 patients presenting to the ER with suspected acute appendicitis were included in the study. All patients underwent both emergency non-contrast CT abdomen screening and ultrasonography. The findings were recorded, and the diagnostic accuracy of each modality was assessed using surgical or histopathological findings as the gold standard.
Results: The 500 patients included, 285 were male and 215 were female, with a mean age of 32.4 years. The sensitivity and specificity of emergency non-contrast CT abdomen screening in diagnosing acute appendicitis were 92.3% and 95.8%, respectively, while for ultrasonography, the sensitivity and specificity were 78.9% and 90.4%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) for emergency non-contrast CT abdomen screening were 89.4% and 96.2%, respectively, compared to 79.8% and 89.7% for ultrasonography. The diagnostic accuracy of emergency non-contrast CT abdomen screening was significantly higher than that of ultrasonography (p<0.001).
Conclusion: Emergency non-contrast CT abdomen screening showed superior diagnostic accuracy compared to ultrasonography in the evaluation of acute appendicitis among patients visiting the ER of Saveetha Medical College, Chennai. The higher sensitivity, specificity, and PPV of CT abdomen screening make it a valuable tool for accurate and timely diagnosis, leading to improved patient management and outcomes. However, considering the radiation exposure associated with CT, careful consideration should be given to the use of this modality in specific patient populations, particularly in women of childbearing age.