Diagnostic performance of diffusion-weighted MR imaging in detecting acute appendicitis in children: Comparison with conventional MRI and surgical findings

Bayraktutan, Ummugulsum; Oral, Akgün; Kantarcı, Mecit; Demir, M; Oğul, Hayri; Yalçın, Ahmet; Kaya, Idris; Salman, Ahmet Bedii; Yiğiter, Murat; Okur, Aylin

doi:10.1002/jmri.24316

Cited by 32 publications

(29 citation statements)

References 20 publications

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“…With the diagnostic boundary set at ≥ 6mm, Bayraktutan et al 25 and Johnson et al 27 reported sensitivities of 92% 25 and 100% 27 and specificities of 100% 25 and 99% 27 respectively. With the diagnostic boundary set at ≥ 7mm, Rosines et al 30 and Herliczek et al 26 reported sensitivities of 94% 30 and 100% 26 and specificities of 100% 30 , 96% 26 respectively.…”

Section: Discussionmentioning

confidence: 99%

Is magnetic resonance imaging a viable alternative to ultrasound as the primary imaging modality in the diagnosis of paediatric appendicitis? A systematic review

2016

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yesBackground: Appendicitis is the most common cause of acute abdominal pain requiring surgical intervention\ud in paediatric patients. Ultrasound is generally the diagnostic imaging modality of choice, followed\ud by CT, where paediatric appendicitis is suspected. However, high operator dependency and\ud diagnostic restrictions related to anatomical and clinical presentation may limit consistency of application.\ud This paper explores whether MRI is a viable alternative to ultrasound as the primary imaging\ud modality.\ud Method: A systematic review of the literature was undertaken. A search of Medline, Cinahl, PubMed\ud Central and Google Scholar was undertaken supplemented by a review of reference lists, author\ud searching and review of NICE evidence base for existing guidelines. Included studies were assessed for\ud bias using the QUADAS-2 quality assessment tool and data were extracted systematically using a purposefully\ud designed electronic data extraction proforma.\ud Results: Seven studies were included in final review. The age range of participants extended from 0 to 19\ud years. Only one study with a patient age range of 0e14 used sedation. Sensitivity estimates from the\ud included studies ranged from 92% to 100% while specificity ranged from 89% to 100%. A significant\ud variation in the number and type of sequences was noted between the studies.\ud Conclusion: MRI offers high sensitivity and specificity comparable to contrast enhanced CT and greater\ud than ultrasound as reported in the literature. Where accessibility is not a restriction, MRI is a viable\ud alternative to ultrasound in the assessment and diagnosis of paediatric appendicitis. Clinical practice\ud recommendations have been provided to facilitate the translation of evidence into practice.Funding info requested 17/03/201

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Section: Discussionmentioning

confidence: 99%

Is magnetic resonance imaging a viable alternative to ultrasound as the primary imaging modality in the diagnosis of paediatric appendicitis? A systematic review

2016

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“…No cases were classified as having indeterminate results in two studies . MRI findings were only classified into two categories (ie, positive vs. negative) in three studies . One study did not clearly explain how indeterminate cases were handled .…”

Section: Resultsmentioning

confidence: 99%

Performance of MRI for suspected appendicitis in pediatric patients and negative appendectomy rate: A systematic review and meta‐analysis

Kim

Suh

Yoon

et al. 2017

Magnetic Resonance Imaging

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“…However, those authors did not include DWI in their MRI protocol, which has proven valuable in other abdominal and bowel diseases [19]. Bayraktutan et al [20] compared DWI with conventional unenhanced MRI and found that the combination of all sequences led to best sensitivity (92%) when evaluating for acute appendicitis. Our study is the first to compare unenhanced MRI versus contrast-enhanced MRI for the detection of appendicitis in pediatric patients, including the use of DWI.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of MRI Versus CT for the Evaluation of Acute Appendicitis in Children and Young Adults

Kinner

Pickhardt

Riedesel

et al. 2017

American Journal of Roentgenology

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OBJECTIVE Appendicitis is frequently diagnosed in the emergency department, most commonly using CT. The purpose of this study was to compare the diagnostic accuracy of contrast-enhanced MRI with that of contrast-enhanced CT for the diagnosis of appendicitis in adolescents when interpreted by abdominal radiologists and pediatric radiologists. SUBJECTS AND METHODS Our study included a prospectively enrolled cohort of 48 patients (12–20 years old) with nontraumatic abdominal pain who underwent CT and MRI. Fellowship-trained abdominal and pediatric radiologists reviewed all CT and MRI studies in randomized order, blinded to patient outcome. Likelihood for appendicitis was rated on a 5-point scale (1, definitely not appendicitis; 5, definitely appendicitis) for CT, the unenhanced portion of the MRI, and the entire contrast-enhanced MRI study. ROC curves were generated and AUC compared for each scan type for all six readers and then stratified by radiologist type. Image test characteristics, interrater reliability, and reading times were compared. RESULTS Sensitivity and specificity were 85.9% (95% CI, 76.2–92.7%) and 93.8% (95% CI, 89.7–96.7%) for unenhanced MRI, 93.6% (95% CI, 85.6–97.9%) and 94.3% (95% CI, 90.2–97%) for contrast-enhanced MRI, and 93.6% (95% CI, 85.6–97.9%) and 94.3% (95% CI, 90.2–97%) for CT. No difference was found in the diagnostic accuracy or interpretation time when comparing abdominal radiologists to pediatric radiologists (CT, 3.0 min vs 2.8 min; contrast-enhanced MRI, 2.4 min vs 1.8 min; unenhanced MRI, 1.5 min vs 2.3 min). Substantial agreement between abdominal and pediatric radiologists was seen for all methods (κ = 0.72–0.83). CONCLUSION The diagnostic accuracy of MRI to diagnose appendicitis was very similar to CT. No statistically significant difference in accuracy was observed between imaging modality or radiologist subspecialty.

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Diagnostic performance of diffusion-weighted MR imaging in detecting acute appendicitis in children: Comparison with conventional MRI and surgical findings

Abstract: The use of combination of DWI and conventional MRI is a valuable technique in the diagnosis of acute appendicitis in children.

Cited by 32 publications

References 20 publications

Is magnetic resonance imaging a viable alternative to ultrasound as the primary imaging modality in the diagnosis of paediatric appendicitis? A systematic review

Is magnetic resonance imaging a viable alternative to ultrasound as the primary imaging modality in the diagnosis of paediatric appendicitis? A systematic review

Performance of MRI for suspected appendicitis in pediatric patients and negative appendectomy rate: A systematic review and meta‐analysis

Diagnostic Accuracy of MRI Versus CT for the Evaluation of Acute Appendicitis in Children and Young Adults

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