Diagnostic performance of computed tomography in differentiating appendiceal diverticulitis from acute appendicitis.
CT is highly specific for diagnosing appendiceal diverticulitis versus acute appendicitis
Diagnostic performance of computed tomography in differentiating appendiceal diverticulitis from acute appendicitis.
Appendiceal diverticulitis is a rare condition; however, it has a higher perforation rate than acute appendicitis and is more frequently associated with appendiceal malignancy.
The aim of this study was to evaluate the diagnostic performance of computed tomography in differentiating appendiceal diverticulitis from acute appendicitis.
Three independent observers retrospectively reviewed axial, coronal, and multiplanar reconstruction images.
Histopathological analysis confirmed appendiceal diverticulitis in 31 (5.8%) patients and acute appendicitis in 500 (94.2%).
Interobserver agreement was substantial (Fleiss' kappa = 0.767).
In patients without periappendiceal abscess (n = 433), sensitivity and specificity improved to 75% and 99%, respectively.
Computed tomography demonstrated moderate sensitivity (65%) and high specificity (98%) for differentiating appendiceal diverticulitis from acute appendicitis.
The diagnostic performance improved in cases without periappendiceal abscess or perforation, suggesting that computed tomography is a reliable tool for identifying appendiceal diverticulitis in patients with uncomplicated disease.