ĐỒNG THUẬN CHẨN ĐOÁN TRÊN CẮT LỚP VI TÍNH VIÊM RUỘT THỪA CẤP

Abstract

Objective: study the inter-observer agreement among radiologists with different level of experience in the diagnosis of acute appendicitis (AA) based on CT imaging. Subjects and methods: A comparing cross-sectional descriptive study of 60 cases with clinically suspected appendicitis, of which 30 patients with postoperative results confirming AA, who underwent abdominal CT at Viet-Duc Friendship hospital from April to October 2022. CT images were read independently by three radiologists with different levels of experience (18 years, 5 years 2 years). The inter-observe agreements in the interpretation of CT findings and the ability of diagnosis of AA among the physicians was compared. Results: 42 females and 18 males were included in the study with a mean age of 41.90 ± 21.42 years (range 5 – 93 years). The inter-observer agreement in the diagnosis of AA based on CT findings showed a good agreement among the radiologists, with kappa values ranging from good to excellent for radiologist A-B, A-C, and all three radiologists, at 0.93, 0.73, and 0.78, respectively (p<0,01).  The appendiceal enlargement had good agreement with kappa values for radiologist A-B, radiologist A-C, and all three radiologists at 0.62, 0.80, and 0.68, respectively (p<0,01). The presence of appendicolith showed good agreement between radiologist A-B and all three radiologists, with kappa values of 0.75 and 0.67, respectively (p<0,01). The signs of fluid collection, intraluminal air, and fat stranding around the appendix had moderate agreement, with kappa ranging from 0.44 to 0.57. Conclusion: There was good agreement among the radiologists in diagnosis of AA on CT scan. The appendiceal enlargement and presence of appendicolith showed good agreement too.