Ct method for visualization of the appendix using a fixed oral dosage of diatrizoate—clinical experience in 525 cases

Purpose: The purpose of this study is to determine if focused CT examinations of the pelvis, utilizing fixed oral dosage of diatrizoate contrast media, improve overall reader confidence in visualization of the appendix. Materials and methods: Five hundred and twenty-five patients referred for, rule out appendicitis, evaluations underwent focused CT examinations of the pelvis following fixed oral dosage of diatrizoate contrast media. A five-point scale was used to assess the effect of contrast enhancement of the distal small bowel, cecum, and appendix on overall reader confidence, and subsequent visualization of the appendix. Results: Bowel preparation was ideal in 504 of 525 (96%) patients. Enhanced supine CT images following oral administration of fixed dosage of diatrizoate had consistently good scores for reader confidence for bowel opacification (4.8±0.1, P<0.005) and visualization of the appendix (3.7±0.1, P<0.005), at 50 min following oral contrast administration. This method improved visualization of the normal appendix in 446 of 504 (88%) patients, with a specificity of 99%. In a patients meeting CT criteria for appendicitis, 21 of 21 (100%) patients were proven at surgery. Conclusion: The use of fixed oral dosage of diatrizoate contrast media resulted in good overall reader confidence to visualize the appendix and peri-appendiceal area, in addition to high specificity and rapid transit time.