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Title of Journal: Emerg Radiol

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Abbravation: Emergency Radiology

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Springer-Verlag

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DOI

10.1002/cmdc.201090063

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1438-1435

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Influence of body habitus and use of oral contrast

Authors: Stephan W Anderson James T Rhea Holly N Milch Al Ozonoff Brian C Lucey Jorge A Soto
Publish Date: 2010/05/23
Volume: 17, Issue: 6, Pages: 445-453
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Abstract

The purpose of this study is to evaluate how body habitus affects reader confidence in diagnosing acute appendicitis and appendiceal visualization using 64 MDCT technology with and without oral contrast We conducted a HIPAA compliant IRB approved study of adult patients presenting to the Emergency Department with nontraumatic abdominal pain Subjects were randomized to two groups 64 MDCT scans performed with oral and intravenous contrast or scans performed solely with intravenous contrast Three radiologists established their confidence about the presence of appendicitis as well as recording whether the appendix was visualized Reader confidence in diagnosing acute appendicitis was compared between the two groups for the three readers The impact of patient BMI and estimated intraabdominal fat on reader confidence in diagnosing appendicitis was determined Finally a comparison of the effect of BMI and intraabdominal fat on appendiceal visualization between the two groups was carried out Three hundred three patients were enrolled in this study There was a statistically significant difference in confidence based on BMI for reader 2 group 1 in diagnosing appendicitis No further statistically significant differences in reader confidence for diagnosing appendicitis based on BMI or intraabdominal fat were identified There was no influence of BMI or intraabdominal fat on appendiceal visualization Increasing BMI was seen to improve reader confidence for one of three readers in patients that received both oral and intravenous contrast No further effects of BMI or intraabdominal fat on confidence in diagnosing or excluding appendicitis were seen Neither BMI nor intraabdominal fat were seen to influence appendiceal visualization

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