The value of unenhanced CT in the diagnosis of acute appendicitis
Palavras-chave:
Computerized tomography in appendicitis, Computerized tomography of the digestive tract, Computerized tomography, Appendix, AppendicitisResumo
OBJETIVO: Estabelecer a eficácia da TC sem contraste EV ou VO no diagnóstico pré-operatório da apendicite aguda. TIPO DE ESTUDO: estudo de acurácia prospectivo, independente. LOCAL: hospital-escola de atenção terciária (instituição mista). PACIENTES: 52 pacientes com suspeita clínico-laboratorial de apendicite aguda. MÉTODO DIAGNÓSTICO: Os exames tomográficos foram realizados sem contraste EV ou VO. O diagnóstico tomográfico de apendicite aguda foi feito na presença de apêndice anormal, apendicolito com flegmão pericecal ou alterações na região apendicular, sem sinais que indicassem um diagnóstico alternativo. VARIÁVEIS ESTUDADAS: eficácia, sensibilidade, especificidade, valor preditivo positivo e negativo, comparando os aspectos tomográficos com os achados intra-operatórios e laudos anatomopatológicos (padrão ouro). RESULTADOS: O diagnóstico definitivo de apendicite aguda foi observado em 44 casos. A eficácia do método foi de 92%; sensibilidade de 91%; especificidade de 100%; o valor preditivo positivo foi de 100% e o valor preditivo negativo de 67%. CONCLUSÃO: A TC sem contraste EV e VO apresenta eficácia global semelhantre à TC com contraste relatada por outros autores, no diagnóstico da apendicite aguda.
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