Hiroshi Sugimura MD, PhD, Presenter: Nothing to Disclose

Ryuzo Ochiai MD, Abstract Co-Author: Nothing to Disclose

Eiji Furukoji MD, PhD, Abstract Co-Author: Nothing to Disclose

Tatefumi Sakae MD, Abstract Co-Author: Nothing to Disclose

Kenichiro Yamaguchi MD, Abstract Co-Author: Nothing to Disclose

Shozo Tamura MD, PhD, Abstract Co-Author: Nothing to Disclose

The vermiform appendix has no constant position and the data on the variations in its postion are limited. Both McBurney's and Lanz's points are the surgical landmark for locating the appendix. The purpose of this study was to show the relation the center of an affected appendix and these points in patients undergoing 3D MDCT.

This study carried out in 62 consecutive patients (29 women, 33 men; mean age, 20.5 years, range 7-84) referred for CT (LightSpeed 16, GE Healthcare) because of acute appendicitis. 3D reconstruction of the MDCT data was performed with a volume rendering (VR) display algorithm. Previous to an appendectomy we indicated the center of the lesion on the VR image. The locations of the base of the lesion of appendicitis and the points were marked on a 3D image that allowed display of the skin surface markings for each patient. The supero-inferior and medio-lateral distances from the level of the center of appendicitis to the level of the tenderness points were measured, and the radial distance was calculated from these measurements. The surgeon identified the affected appendix by operations.

The affected appendix was found at the same portion of the 3D image in all cases. The appendix was exactly at McBurney's point in only 11% of the patients. It was at Lanz's point in 16%. In 32% of the cases the appendix was within 3 cm from McBurney's point, in 52% it was within 3cm from Lanz's point. In 42% of the cases it was more than 5cm away from McBurney's point, in 11% of the cases away from Lanz's point. Mean +/- SD superoinferior, mediolateral, and radial distances between the appendix and McBurney's point were 25.5 +/- 26.6, 17.6 +/- 22.0, and 41.7 +/- 20.1mm, respectively. Those from Lanz's point were 9.4 +/- 24.5, 10.1 +/- 17.2, and 29.6 +/- 14.2mm. In only one patient the lesion was discovered outside the Rapp's area.

The affected appendix was found near the Lanz's point than the McBurney's point. However, the location of the appendicitis varies widely among individuals, and both McBurney's and Lanz's point have limitations as a surgical landmark. The information about the location of the affected appendix from 3D data is beneficial for surgeons performing appendectomy.

MDCT can clearly demonstrate appendicitis, and the information about the location of the affected appendix from 3D data is beneficial for surgeons performing appendectomy.

Sugimura, H, Ochiai, R, Furukoji, E, Sakae, T, Yamaguchi, K, Tamura, S, Localization of Appendicitis Using MDCT in Comparison with Both McBurney's and Lanz's Points.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6016334.html