Contribution of Diffusion-Weighted Magnetic Resonance Imaging in the Follow-Up of Uncomplicated Acute Appendicitis: Initial Results

Özdemir, Oğuz; Metin, Nurgül Orhan; Metin, Yavuz; Kalcan, Süleyman; Küpeli, Ali

doi:10.5812/iranjradiol.56033

Cited by 1 publication

(1 citation statement)

References 33 publications

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“…We identified 12 studies that reported on topics unrelated to diagnostic accuracy. 5 , 50 – 60 These studies are summarised in Table 4 : three reported on trends of MRI use, 51 , 53 , 55 two were reports about visualisation of the normal appendix, 58 , 59 two were analyses of financial implications, 5 , 60 one was a secondary study comparing simple versus perforated appendicitis using different imaging modalities, 50 one reported on MRI to assess treatment response in non-operatively managed appendicitis, 52 one was a decision analysis, 56 one was a radiologist training report, 57 and one was a survey of imaging prioritisation. 54 …”

Section: Resultsmentioning

confidence: 99%

Rapid MRI Abdomen for Assessment of Clinically Suspected Acute Appendicitis in the General Adult Population: a Systematic Review

Kim

Woodham

Chen

et al. 2023

Journal of Gastrointestinal Surgery

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Objectives To perform a systematic review on the use of magnetic resonance imaging (MRI) of the abdomen to evaluate clinically suspected appendicitis in the general adult population. We examined the diagnostic accuracy, the reported trends of MRI use, and the factors that affect the utility of MRI abdomen, including study duration and cost-benefits. Methods We conducted a systematic literature search on PubMed, MEDLINE, Embase, Web of Science, and Cochrane Library databases. We enrolled primary studies investigating the use of MRI in diagnosing appendicitis in the general adult population, excluding studies that predominantly reported on populations not representative of typical adult appendicitis presentations, such as those focusing on paediatric or pregnant populations. Results Twenty-seven eligible primary studies and 6 secondary studies were included, totaling 2,044 patients from eight countries. The sensitivity and specificity of MRI for diagnosing appendicitis were 96% (95% CI: 93–97%) and 93% (95% CI: 80–98%), respectively. MRI can identify complicated appendicitis and accurately propose alternative diagnoses. The duration of MRI protocols in each primary study ranged between 2.26 and 30 minutes, and only one study used intravenous contrast agents in addition to the non-contrast sequences. Decision analysis suggests significant benefits for replacing computed tomography (CT) with MRI and a potential for cost reduction. Reported trends in MRI usage showed minimal utilisation in diagnostic settings even when MRI was available. Conclusions MRI accurately diagnoses appendicitis in the general adult population and improves the identification of complicated appendicitis or alternative diagnoses compared to other modalities using a single, rapid investigation.

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