Abdominal Imaging - Original Article

Alvarado scores and pain onset in relation to multislice CT findings in acute appendicitis

  • Erkan Yıldırım
  • Erdal Karagülle
  • İsmail Kırbaş
  • Emin Türk
  • Barış Hasdoğan
  • Mehmet Tekşam
  • Mehmet Coşkun

Received Date: 15.05.2007 Accepted Date: 05.09.2007 Diagn Interv Radiol 2008;14(1):14-18


To determine the correlation between clinical and multislice computed tomography (MSCT) findings of early- and late-stage acute appendicitis.


The study was conducted between June 2003 and February 2006 with 143 patients. Patients were divided into 3 groups according to Alvarado scores: group 1 (n = 18; 13%; score: 1-4), group 2 (n = 70; 49%; score: 5-7), and group 3 (n = 55; 38%; score: 8-10). Abdominal MSCT results were compared to histopathological diagnoses. Patients were then divided into 2 other groups according to pain onset (MSCT performed within the first 12 h of pain onset and MSCT performed thereafter).


Histopathological findings were normal in 13 of the 143 patients (9%). The positive predictive value of MSCT did not significantly differ between the 3 Alvarado groups (92.8% in group 1, 95.1% in group 2, and 98.0% in group 3). Additionally, the positive predictive value of MSCT did not differ whether the scans were performed within the first 12 h of pain onset or thereafter (88% and 89%, respectively; P = 0.89).


MSCT should be performed even in patients in whom the clinical suspicion of appendicitis is low. MSCT is effective in patients with early-stage appendicitis.

Keywords: acute appendicitis • multislice computed tomography