MR Imaging Evaluation of Acute Appendicitis in Pregnancy

Pedrosa, Iván; Levine, Deborah; Eyvazzadeh, Aimee D.; Siewert, Bettina; Ngo, Long; Rofsky, Neil M.

doi:10.1148/radiol.2383050146

Cited by 270 publications

(128 citation statements)

References 28 publications

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“…MRI has been reported to obtain good results for excluding or detecting appendicitis [13][14][15][16][17]19]. Our prospective study in a large group of patients confirms that MRI yields excellent diagnostic results and markedly decreases the negative appendectomy rate, without an increase in perforation rate.…”

Section: Discussionsupporting

confidence: 79%

“…Technological developments have made ultrafast sequences possible, resulting in shorter examination times and fewer motion artifacts. Detection of appendicitis with MRI has been published in a small group of pregnant and non-pregnant patients [13][14][15][16][17][18][19]. This is, to our knowledge, the first prospective blinded clinical study, in more than 100 patients, to evaluate MRI in patients clinically suspected of having appendicitis.…”

Section: Introductionmentioning

confidence: 99%

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A simple MRI protocol in patients with clinically suspected appendicitis: results in 138 patients and effect on outcome of appendectomy

et al. 2009

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To establish the value of breathhold magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis. Over a 14-month period, 138 patients clinically suspected of having appendicitis were evaluated prospectively with MRI and comprised the study group. Fast turbo spin-echo breathhold T1, T2 and T2 fat suppression sequences were used in coronal and axial planes. The imaging results were recorded separately and subsequently correlated with clinical, radiological and histopathological follow-up. The effect of imaging strategies in patients suspected of appendicitis on hospital resources was calculated. Sixty-two of the 138 patients had a histopathologically proven appendicitis. MRI determined appendicitis in 63 patients, with one examination being false positive. The resulting sensitivity and specificity were 100% and 99%, respectively. MRI showed an alternative diagnosis in 41 of the 75 remaining patients. In 22 of the remaining 34 patients, a normal appendix was depicted with MRI. In two patients, where MRI showed no appendicitis, an alternative diagnosis or normal appendix, an unnecessary appendectomy was performed. The overall effect of using MRI in patients suspected of appendicitis on the use of hospital resources could have been a net saving between 55,746 euros and 72,534 euros. MRI has a high accuracy in detecting and excluding appendicitis, an alternative diagnosis or showing the normal appendix, and can be a valuable and cost-effective tool in the workup of patients clinically suspected of having appendicitis.

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Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

A simple MRI protocol in patients with clinically suspected appendicitis: results in 138 patients and effect on outcome of appendectomy

et al. 2009

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“…28 Several studies have reported non-visualization of the appendix in a large percentage of pregnant women with suspected appendicitis. [29][30][31][32][33] However, in a review of studies on the value of ultrasound diagnostics during appendicitis in pregnancy, sensitivity ranged from 67 to 100% and specificity of 83 to 96%, compared with the general population, in which sensitivity and specificity were 86 and 96%, respectively. 34 Several factors influence the performance of ultrasound diagnosis of appendicitis in pregnancy, including gestational age, body mass index (BMI), and most importantly, the training and experience of the examiner.…”

Section: 28mentioning

confidence: 99%

Acute appendicitis in pregnancy: literature review

Neto

Amorim²,

Nóbrega³

2015

Rev. Assoc. Med. Bras.

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Conflict of interest: noneIntroduction: suspected appendicitis is the most common indication for surgery in non-obstetric conditions during pregnancy and occurs in about one in 500 to one in 635 pregnancies per year. This occurs more often in the second trimester of pregnancy. Acute appendicitis is the most common general surgical problem encountered during pregnancy. Methods: a literature review on research of scientific articles, under the terms "acute appendicitis" and "pregnancy", in PubMed, Lilacs/SciELO, Scopus, Cochrane Library and Uptodate databases.Results: the clinical manifestations of appendicitis are similar to non-pregnant women, however, without a classic presentation, which often occurs, diagnosis is difficult and must be supported by imaging. Discussion: clinical diagnosis should be strongly suspected in pregnant women with classic findings such as abdominal pain that migrates to the right lower quadrant. The main purpose of imaging is to reduce delays in surgical intervention due to diagnostic uncertainty. A secondary objective is to reduce, but not eliminate, the negative appendectomy rate. Differential diagnosis of suspected acute appendicitis usually includes pathologies considered in non-pregnant people. Conclusion: the imaging study of choice is ultrasound, MRI may be used when the former is not conclusive and, as a last resort, a CT scan can be performed. The treatment remains appendectomy by laparotomy, since the feasibility of video-assisted surgery in these cases remains controversial.

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“…Si el apéndice mide entre 6 y 7 mm de diámetro, presenta contenido de alta señal T2 pero no se identifican cambios inflamatorios en el tejido adiposo o engrosamiento de sus paredes, se debe realizar seguimiento de la paciente, al ser los hallazgos no concluyentes (Figura 2a,b) Se ha descrito una sensibilidad de 100% y especificidad de 94% en el diagnóstico de apendicitis durante el embarazo mediante RM (4) . …”

Section: Apendicitis Agudaunclassified

Abdomen agudo en el embarazo: Evaluación por resonancia magnética

et al. 2015

Rev. chil. radiol.

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MR Imaging Evaluation of Acute Appendicitis in Pregnancy

Abstract: MR imaging is an excellent modality for use in excluding acute appendicitis in pregnant women who present with acute abdominal pain and in whom a normal appendix is not visualized at US.

Cited by 270 publications

References 28 publications

A simple MRI protocol in patients with clinically suspected appendicitis: results in 138 patients and effect on outcome of appendectomy

A simple MRI protocol in patients with clinically suspected appendicitis: results in 138 patients and effect on outcome of appendectomy

Acute appendicitis in pregnancy: literature review

Abdomen agudo en el embarazo: Evaluación por resonancia magnética

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