The Role of Multidetector Computed Tomography in Evaluating Acute Right Iliac Fossa Pain (Code-T0073)

Background: This study explores the role of multidetector computed tomography (MDCT) in diagnosing acute right iliac fossa (RIF) pain. It evaluates the diagnostic accuracy, clinical relevance, and limitations of MDCT through a combination of literature review and institutional data analysis. The findings aim to optimize the utilization of MDCT in identifying and managing RIF pain, thereby improving patient outcomes and guiding clinical decisions.

Aim and Objective:

Aims:

1. To assess the accuracy and efficacy of MDCT (128 slices) in diagnosing and differentiating the various pathological conditions causing right iliac fossa pain.

2. To correlate the cause of right iliac fossa pain diagnosed radiologically with histopathological findings.

Objectives:

1. To analyze the effectiveness of MDCT in evaluating the various underlying pathologies in acute right iliac fossa pain

2. To correlate the MDCT imaging findings with surgical/histopathological findings in patients undergoing surgery or by repeat MDCT/other radiological modalities in conservatively managed patients.

Materials and Methods: Informed consent was obtained from 250 participants or their guardians. Imaging was conducted using a 128-slice CT scanner (Philips IQon Spectral CT). Non-enhanced CT scans were performed from the diaphragm to the pelvis, with contrast-enhanced scans conducted in cases requiring further evaluation as determined by the consulting surgeon. Advanced imaging techniques such as multiplanar reconstructions, maximum intensity projections, and 3D volume rendering were utilized for diagnostic purposes. Repeat MDCT or additional radiological investigations were performed when necessary. Participant data were anonymized, and confidentiality was strictly maintained.

Results: Analysis revealed that 89.2% of cases identified as positive by MDCT required surgical intervention, underscoring its high diagnostic reliability. Sensitivity was measured at 96.1%, reflecting MDCT's effectiveness in detecting true positives. Specificity was moderate at 72.3%, indicating a potential for false-positive results. These findings are consistent with existing research, including a study by Lopez et al., which reported 34.8% of MDCT-identified cases requiring surgery. The study provides a comprehensive evaluation of MDCT’s role in predicting RIF pain and its diagnostic accuracy.

Conclusion: MDCT using a 128-slice scanner proves to be a highly sensitive diagnostic tool for evaluating acute RIF pain, with significant accuracy in identifying surgical cases. While moderate specificity suggests the need for cautious interpretation, its clinical utility remains robust. The correlation of MDCT findings with histopathological results further validates its role in managing RIF pain. These findings support the continued use of MDCT in enhancing diagnostic precision and patient care.

Keywords: MDCT, Right Iliac Fossa Pain, Diagnostic Accuracy, Surgical Correlation, Histopathology, Sensitivity, Specificity, 128-Slice CT Scanner.