Comparison of combined oral and iv contrast-enhanced versus single iv contrast-enhanced mdct for the detection of acute appendicitis

Objective: The aim of our study was to compare the diagnostic ability of oral added intravenous (IV) contrastenhanced multidetector computed tomography (MDCT) versus only IV contrast-enhanced MDCT in diagnosing of acute appendicitis.
Materials and methods: MDCT images of 200 patients were evaluated prospectively in this study. Patients were randomized into one of two groups: Group 1 (Gp1) patients underwent 16-MDCT performed with oral and IV contrast-enhanced and Group 2 (Gp2) subjects underwent 16-MDCT with only IV contrast-enhanced protocol. Final decision was based on histopathologic operative data and follow-up of patients.
Results: In Gp1, Reader1 had 96.9% and 98.5% and Reader2 had 84% and 94.7% sensitivity and specificity values respectively. For Gp2, the values for Reader1 were 81% and 94%. For Reader2 in Gp2, the values were 76% and 91%. We achieved higher sensitivity and specificity values with combined contrast administration versus only IV contrastenhanced MDCT imaging. However, there was no statistically significant differences between two readers in the AUC values of each group for the detection of acute appendicitis.
Conclusion: It is statistically concluded that oral contrast do not contribute to the a better accuracy. So in the routine practice, oral contrast has not to be recommended.