Magnetic resonance imaging (MRI) for diagnosis of acute appendicitis

D’Souza, Nigel; Thaventhiran, Anthony; Beable, Richard; Higginson, Antony; Rud, Bo

doi:10.1002/14651858.cd012028

Cited by 8 publications

(5 citation statements)

References 48 publications

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“…MRI is an imaging technique that holds promise and is under review. 17 It has a diagnostic accuracy equivalent to CT, without the radiation exposure. New MRI protocols have reduced on-table scan time to less than 3 minutes in children.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of routine imaging of suspected appendicitis

D’Souza

Marsden

Bottomley

et al. 2018

annals

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Introduction The misdiagnosis of appendicitis and consequent removal of a normal appendix occurs in one in five patients in the UK. On the contrary, in healthcare systems with routine cross-sectional imaging of suspected appendicitis, the negative appendicectomy rate is around 5%. If we could reduce the rate in the UK to similar numbers, would this be cost effective? This study aimed to calculate the financial impact of negative appendicectomy at the Queen Alexandra Hospital and to explore whether a policy of routine imaging of such patients could reduce hospital costs. Materials and methods We performed a retrospective analysis of all appendicectomies over a 1-year period at our institution. Data were extracted on outcomes including appendix histology, operative time and length of stay to calculate the negative appendicectomy rate and to analyse costs. Results A total of 531 patients over 5 years of age had an appendicectomy. The negative appendicectomy rate was 22% (115/531). The additional financial costs of negative appendicectomy to the hospital during this period were £270,861. Universal imaging of all patients with right iliac fossa pain that could result in a 5% negative appendicectomy rate would cost between £67,200 and £165,600 per year but could save £33,896 (magnetic resonance imaging), £105,896 (computed tomography) or £132,296 (ultrasound) depending on imaging modality used. Conclusions Negative appendicectomy is still too frequent and results in additional financial burden to the health service. Routine imaging of patients with suspected appendicitis would not only reduce the negative appendicectomy rate but could lead to cost savings and a better service for our patients.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of routine imaging of suspected appendicitis

D’Souza

Marsden

Bottomley

et al. 2018

annals

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“…Most patients with appendicitis are white-skinned (74%), with a low incidence in black-skinned people (<5%) [ [3] , [4] , [5] ]. Annually, approximately 310,000 appendectomies are performed in the United States and 47,000 in the United Kingdom, at a mean cost of US $ 33,000 per patient in the United States [ [6] , [7] , [8] ]. Studies in the United Kingdom have indicated that more than one-fifth of the appendectomies show normal histopathological results [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Differences between inflamed and non inflamed appendices diagnosed as acute appendicitis

Nascimento

Brandt

Petroianu

2021

Annals of Medicine and Surgery

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“…Ultrasonography avoids the radiation exposure of CT but is not sufficient as the sole diagnostic method in the differentiation of complicated versus uncomplicated AA [ 29 ]. The use of MRI presents with high sensitivity and specificity but entails costs and is not universally available in centers that treat children with AA [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Mean Platelet Volume in the Diagnosis of Acute Appendicitis in the Pediatric Population: A Systematic Review and Meta-Analysis

et al. 2022

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Background: Mean Platelet Volume (MPV) has been suggested as a biomarker for acute appendicitis (AA) in the adult population. The utility of MPV in pediatric AA remains vague. This systematic review and meta-analysis aimed to systematically summarize and compare all relevant data on MPV as a diagnostic biomarker for AA in children. Methods: Databases were systematically searched using keywords ((mean platelet volume) OR mpv) AND (appendicitis). The inclusion criteria were all comparative studies of MPV in children aged less than 18 years and diagnosed with AA. Two authors independently assessed the methodological quality using the Downs and Black scale. Results: We included fourteen studies in the final meta-analysis; most were retrospective. Eight studies compared the MPV values between AA and non-AA; four studies compared the same between AA and healthy controls; two studies compared the MPV values among all three groups. The estimated heterogeneity among the studies for all outcomes was high and statistically significant. The pooling the data showed no statistically significant difference in MPV (weighted mean difference (WMD) = −0.42, 95% CI = (−1.04, 0.20), p = 0.19) between AA and healthy controls or AA and non-AA cases (WMD = 0.01, 95% CI = (−0.15, 0.17), p = 0.90). Conclusion: While MPV levels seem to have some utility in adult AA diagnosis, MPV levels should not dictate treatment options in pediatric AA.

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Magnetic resonance imaging (MRI) for diagnosis of acute appendicitis

Cited by 8 publications

References 48 publications

Cost-effectiveness of routine imaging of suspected appendicitis

Cost-effectiveness of routine imaging of suspected appendicitis

Differences between inflamed and non inflamed appendices diagnosed as acute appendicitis

Mean Platelet Volume in the Diagnosis of Acute Appendicitis in the Pediatric Population: A Systematic Review and Meta-Analysis

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