VISUALIZATION OF NORMAL APPENDIX ON MDCT; QUESTIONING THE SIZE CRITERIA FOR APPENDICITIS!

Abstract

Objective: To evaluate the frequency of visualization, position, caliber of appendix on MDCT in patients without any clinical suspicion of appendicitis or history of prior surgery. Materials and Methods: 100 CT Scans were prospectively reviewed and radiologists were aware of the history at the time of image interpretation. Both unenhanced and contrast studies were included in the study. Two Radiologists reviewed the scans together, assessing axial, coronal and sagital images. The frequency of the visualization of appendix was recorded with the assessment of position and caliber. Results: Normal appendix visualized in 98% of patients and the range of normal caliber was found to be 4 – 11 mm. Conclusion: MDCT is extremely useful for visualization of normal appendix. The normal appendix is very variable in its position and caliber. The understanding of variation in the thickness of the normal appendix and wide variation in its position and length will help in the evaluation of appendix and will improves accuracy in the diagnosis of appendix related pathologies especially appendicitis. In the absence of other signs, the diagnosis of acute appendicitis should be made with extreme caution without considering the thickness of the appendix solely. KEY WORDS: Normal appendix, MDCT, size criteria