The Relationship between Appendix Visibility on Non-Contrast Computed Tomography and Visceral Obesity: A Retrospective Cross-Sectional Study

Objective: This study aims to evaluate the visibility of the appendix on non-contrast computed tomography (NCCT) in patients with high visceral obesity, thereby reducing the need for intravenous (IV) contrast.Methods: The study population consists of adult patients who underwent NCCT imaging at a tertiary hospital between January 2021 and January 2022. The data were collected from electronic medical records and imaging databases, including age, gender, CT findings, and visceral fat area (VFA) measurement. Descriptive statistics, chi-square test, Spearman's rho test, and logistic regression analysis were used for data analysis.Results: In this study of 1562 patients (720 female, 842 male), we examined the relationship between appendix visibility, age, and visceral obesity. The appendix was visualized in 1390 patients (89%) and could not be marked in 172 patients (11%). We found that appendix visualization was significantly higher in patients with a high visceral fat area (VFA > 130) compared to those with a low VFA (p < 0.001).Conclusions: The results highlight the potential importance of considering appendix visibility as a radiological consequence of visceral obesity. NCCT will be useful for visualizing the appendix in patients with high VFA and may reduce the need for IV contrast.