Evaluation of the Amount of Contrast Material used in Abdominal CTExaminations to investigate the Diagnosis of Appendicolith: Aretrospective study

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Background: Appendicoliths are calcified deposits within the appendix and are considered important diagnosticindicators in acute appendicitis. Contrast-enhanced computed tomography (CT) is a key imaging modality forappendicitis diagnosis, but the optimal amount of contrast material needed for clear visualization of appendicolithsremains unclear. Balancing diagnostic clarity with contrast dose minimization is critical to reduce potentialadverse reactions and cost.Objective: To evaluate the correlation between the amount of intravenous contrast material administered duringabdominal CT and the detection rates of appendicoliths in patients with suspected appendicitis.Materials and Methods: This retrospective study analyzed abdominal CT scans performed between May 2020to April 2021 in patients presenting with right lower quadrant abdominal pain. A total of 135 patients wereincluded (sample size: 100–150), divided into three groups based on contrast volume used: low-dose (≤80 mL),standard-dose (81–100 mL), and high-dose (>100 mL). Radiological detection of appendicoliths was assessed bytwo experienced radiologists blinded to the contrast volume. Data on patient demographics, imaging parameters,and appendicolith visibility were recorded and analyzed statistically.Results: Among the 135 patients, appendicoliths were detected in 42 cases (31.1%). Detection rates were 22.5%,35.5%, and 37.8% in the low-, standard-, and high-dose groups, respectively. A statistically significantimprovement in appendicolith detection was observed in the standard and high-dose groups compared to the low-dose group (p < 0.05). However, the difference between standard and high doses was not statistically significant(p > 0.05).Conclusion: While higher volumes of contrast improve appendicolith detection on abdominal CT, standard doses(81–100 mL) may offer an optimal balance between diagnostic accuracy and contrast load. These findings suggesta need for protocol refinement to minimize contrast-related risks without compromising diagnostic efficacy.

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