How to differentiate acute pelvic inflammatory disease from acute appendicitis ? A decision tree based on CT findings.

Purpose: To construct a decision tree based on CT findings to differentiate acute pelvic inflammatory disease (PID) from acute appendicitis (AA) in women with lower abdominal pain and inflammatory syndrome.Materials and Methods: This retrospective study was approved by our institutional review board...

Descripción completa

Detalles Bibliográficos
Publicado en:European Radiology Vol. 28; no. 2; pp. 673 - 683
Autores principales: El Hentour, Kim, Millet, Ingrid, Pages-Bouic, Emmanuelle, Curros-Doyon, Fernanda, Molinari, Nicolas, Taourel, Patrice
Formato: Journal Article
Publicado: Springer Nature Feb2018
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=126970433&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 126970433
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        09387994
        NPH
      jtl: European Radiology
      issn: 09387994
      maglogo: N
    pubinfo:
      dt: Feb2018
      vid: 28
      iid: 2
      pid: 237
      pub: Springer Nature
      place: New York, New York
    artinfo:
      ui:
        126970433
        126970433
        143914030
        NLM28894927
        10.1007/s00330-017-5032-4
        NLM28894927
        126970433
      ppf: 673
      ppct: 10
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: P
      tig:
        atl: How to differentiate acute pelvic inflammatory disease from acute appendicitis ? A decision tree based on CT findings.
      aug:
        au:
          El Hentour, Kim
          Millet, Ingrid
          Pages-Bouic, Emmanuelle
          Curros-Doyon, Fernanda
          Molinari, Nicolas
          Taourel, Patrice
        affil: Department of Medical Imaging, Lapeyronie Hospital, 371 Avenue du Doyen Gaston Giraud, 34295, Montpellier, France
      sug:
        subj:
          Tomography, X-Ray Computed Methods
          Appendix
          Pelvic Inflammatory Disease Diagnosis
          Appendicitis Diagnosis
          Decision Trees
          Algorithms
          Retrospective Design
          Female
          Acute Disease
          Diagnosis, Differential
          Adult
          Middle Age
          Adolescence
          Scales
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Adolescent: 13-18 years
          Female
      ab: Purpose: To construct a decision tree based on CT findings to differentiate acute pelvic inflammatory disease (PID) from acute appendicitis (AA) in women with lower abdominal pain and inflammatory syndrome.Materials and Methods: This retrospective study was approved by our institutional review board and informed consent was waived. Contrast-enhanced CT studies of 109 women with acute PID and 218 age-matched women with AA were retrospectively and independently reviewed by two radiologists to identify CT findings predictive of PID or AA. Surgical and laboratory data were used for the PID and AA reference standard. Appropriate tests were performed to compare PID and AA and a CT decision tree using the classification and regression tree (CART) algorithm was generated.Results: The median patient age was 28 years (interquartile range, 22-39 years). According to the decision tree, an appendiceal diameter ≥ 7 mm was the most discriminating criterion for differentiating acute PID and AA, followed by a left tubal diameter ≥ 10 mm, with a global accuracy of 98.2 % (95 % CI: 96-99.4).Conclusion: Appendiceal diameter and left tubal thickening are the most discriminating CT criteria for differentiating acute PID from AA.Key Points: • Appendiceal diameter and marked left tubal thickening allow differentiating PID from AA. • PID should be considered if appendiceal diameter is < 7 mm. • Marked left tubal diameter indicates PID rather than AA when enlarged appendix. • No pathological CT findings were identified in 5 % of PID patients.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N