MRI of acute appendicitis

Mervak, Benjamin M.; Wilson, Sarah Beth; Handly, Brian; Altun, Ersan; Burke, Lauren M.

doi:10.1002/jmri.26709

Cited by 26 publications

(16 citation statements)

References 46 publications

(96 reference statements)

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“…Pedroza et al [ 17 ] determined that the false positivity rate was high and the negative appendectomy rate was 29%. But in a recent meta-analysis, the diagnostic value of MRI in acute appendicitis was reported to be 96%, with a sensitivity and specificity that was either similar or better than CT [ 18 ]. In obstetric cases, the rate of negative appendectomy in suspected appendicitis cases was reported as 25-50% in another study [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Appendicitis During Pregnancy: A Case Series of 42 Pregnant Women

Akın¹,

Birben²,

Akkurt³

et al. 2021

Cureus

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Section: Discussionmentioning

confidence: 99%

Acute Appendicitis During Pregnancy: A Case Series of 42 Pregnant Women

Akın¹,

Birben²,

Akkurt³

et al. 2021

Cureus

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“…19 Similarly, in 4 studies on the diagnostic certainty of CT for suspected pediatric appendicitis, high sensitivity and specificity rates of 95% (95% CI: 92-97%) and 92% (95% CI: 90-94%) were observed, respectively (14). Unlike CT, MRI lacks the long-term risks associated with ionizing radiation, and clinicians have argued for MRI to supplant CT. 20,22,23,29 The absence of secondary MRI findings of peri-appendicular inflammation can help rule out appendicitis, and secondary findings may improve clinicians' diagnostic acumen. High negative predictive values (97.9-100%) have been observed with incomplete/non-visualized appendixes and no secondary signs of inflammation on MRI, suggesting that these studies could be classified as negative.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…However, increases in the availability and accessibility of MRI, faster effective sequencing techniques, and diagnostic accuracy could improve its use. 20,21 Although MRI has been offered as an optimal secondary imaging modality following equivocal US 14,18,22,23 and considered a viable primary imaging modality in locations with 24-hour access, 24 it is infrequently utilized for pediatric appendicitis in Canada. 5 The primary purpose of this study was to identify the proportion of children with initial equivocal US studies in whom MRI determined a positive or negative result.…”

Section: Introductionmentioning

confidence: 99%

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Magnetic Resonance Imaging Provides Useful Diagnostic Information Following Equivocal Ultrasound in Children With Suspected Appendicitis

et al. 2021

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Purpose: In Canada, ultrasonography is the primary imaging modality for children with suspected appendicitis, yet equivocal studies are common. Magnetic resonance imaging provides promise as an adjunct imaging strategy. The primary objective of this study was to determine the proportion of children with suspected appendicitis and equivocal ultrasound where magnetic resonance imaging determined a diagnosis. Methods: A prospective consecutive cohort of children aged 5-17 years presenting to a tertiary pediatric Emergency Department with suspected appendicitis were enrolled. Participants underwent diagnostic and management strategies according to our local suspected appendicitis pathway, followed by magnetic resonance (Siemens Avanto 1.5 Tesla) imaging. Sub-specialty pediatric radiologists reported all images. Results: Magnetic resonance imaging was performed in 101 children with suspected appendicitis. The mean age was 11.9 (SD 3.4) years and median Pediatric Appendicitis Score was 6 [IQR 4,8]. Ultrasonography was completed in 98/101 (97.0%). Of 53/98 (54.1%) with equivocal ultrasound, magnetic resonance imaging provided further diagnostic information in 41 (77.4%; 10 positive, 31 negative; 12 remained equivocal). Secondary findings of appendicitis on magnetic resonance imaging in children with equivocal ultrasound included abdominal free fluid (24, 45.3%), peri-appendiceal fluid (12, 22.6%), intraluminal appendiceal fluid (9, 17.0%), fat stranding (8, 15.1%), appendicolith (2, 3.8%), and peri-appendiceal abscess (1, 1.9%). The observed agreement between magnetic resonance imaging results and final diagnosis was 94.9% (kappa = 0.89).

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“…In some centers, especially in the United States, the use in emergency of nuclear magnetic resonance (NMR) has become routine in the management of acute abdominal pain in women of childbearing age and in pregnant women [26,27]. Magnetic…”

Section: Nuclear Magnetic Resonance (Nmr)mentioning

confidence: 99%

"Acute Abdomen in Woman of Childbearing Age: Appendicitis or Pelvic Inflammatory Disease? A Systematic Review"

Perrone¹

2021

BJSTR

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Acute abdomen is a clinical presentation that requires emergency surgical treatment in many cases, rapid diagnosis is oftentimes essential. The diagnoses associated with an acute abdomen vary according to age and gender [1], and it is more difficult in young women, in which it is necessary to distinguish between gynecological and non-gynecological diseases (Table 1).Non-gynecological causes include appendicitis, which remains one of the main causes of acute abdomen in childbearing women. The diagnosis of acute appendicitis is essentially clinical. Appendicitis can initially present with periumbilical pain that migrates to the right ARTICLE INFO ABSTRACTAcute abdomen in women of childbearing age is a clinical presentation that requires emergency surgical treatment in many cases and rapid diagnosis is oftentimes essential. Most are the causes of acute abdomen: gynecological (ectopic pregnancy, ovarian torsion, ovarian cysts, endometriosis, pelvic inflammatory disease) and non-gynecological (appendicitis, Crohn's disease, Meckel's diverticulitis, sigmoid diverticulitis, perforated peptic ulcer, viral gastroenteritis, hernias, urological disease). Appendicitis and pelvic inflammatory disease (PID) are two of the most common causes of abdominal pain in women of childbearing age. This article is a systematic review of literature of the differential diagnosis between appendicitis and PID. The diagnosis is clinical, laboratory and radiological. When the sign and symptoms and the biochemical markers are nonspecific abdominal ultrasound (US) is the first radiological test that is performed, but the computer tomography (CT) remains the best specific and sensible exam for the differential diagnosis. Nuclear Magnetic Resonance is performed when CT is contraindicated. Other test like transvaginal ultrasound is a relatively simple and inexpensive diagnostic test that could easily complement the classic abdominal US and be part of the routine diagnostic protocol of women with acute abdominal pain. Therefore, a careful management of the patient starting from the clinical examination and passing through the laboratory and radiological characteristics is necessary.

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MRI of acute appendicitis

Cited by 26 publications

References 46 publications

Acute Appendicitis During Pregnancy: A Case Series of 42 Pregnant Women

Acute Appendicitis During Pregnancy: A Case Series of 42 Pregnant Women

Magnetic Resonance Imaging Provides Useful Diagnostic Information Following Equivocal Ultrasound in Children With Suspected Appendicitis

"Acute Abdomen in Woman of Childbearing Age: Appendicitis or Pelvic Inflammatory Disease? A Systematic Review"

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