Imaging for Accurate Diagnosis of Acute Appendicitis in Adults

Abstract

Background:
Acute appendicitis is a common surgical emergency requiring timely and accurate diagnosis to avoid complications. Ultrasound (US) and computed tomography (CT) imaging are widely used diagnostic modalities. This study compares the diagnostic performance of US and CT in adults presenting with suspected acute appendicitis.
Methods:
This prospective study evaluated 120 adult patients (60 males, 60 females; mean age: 34 years; range: 18–65 years) presenting with clinical signs of acute appendicitis. Each patient underwent US and CT imaging. Diagnostic metrics—sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy—were calculated for each modality using surgical or histopathological confirmation as the reference standard.
Results:
• Ultrasound: Sensitivity: 76%, Specificity: 88%, PPV: 84%, NPV: 81%, Accuracy: 80%.
• CT: Sensitivity: 95%, Specificity: 93%, PPV: 92%, NPV: 96%, Accuracy: 94%.
CT demonstrated significantly higher sensitivity (p < 0.05) and overall accuracy compared to US, while differences in specificity were not statistically significant (p > 0.05).
Conclusion:
CT is superior to ultrasound for diagnosing acute appendicitis in adults due to its higher sensitivity and accuracy, particularly in ambiguous cases. However, US remains a valuable first-line tool in select populations due to its safety and non-invasive nature.