Literature DB >> 15591434

Right-lower-quadrant pain and suspected appendicitis in pregnant women: evaluation with MR imaging--initial experience.

Aytekin Oto1, Randy D Ernst, Rajeev Shah, Mert Koroglu, Gregory Chaljub, Alfredo F Gei, Nikolaos Zacharias, George Saade.   

Abstract

PURPOSE: To determine if there is a role for magnetic resonance (MR) imaging in evaluation of pregnant women with acute right-lower-quadrant pain in whom acute appendicitis is suspected.
MATERIALS AND METHODS: Informed consent and institutional review board approval were obtained. Images obtained with a 1.5-T MR imager and medical records of 23 pregnant women (age range, 19-34 years; mean age, 24.7 years) who presented with acute right-lower-quadrant pain were retrospectively reviewed. MR protocol included use of transverse, coronal, and sagittal noncontiguous T2-weighted single-shot fast spin-echo (SE) sequences; transverse fat-suppressed T2-weighted fast SE sequences; transverse T1-weighted gradient-recalled-echo sequences; and transverse and coronal short inversion time inversion-recovery sequences performed through the lower abdomen and pelvis. MR findings were evaluated by two radiologists and compared with surgical and pathologic findings and clinical follow-up data.
RESULTS: Appendix was detected in 20 (86.9%) of 23 patients. Seven patients underwent surgery; four had acute appendicitis, and three had ovarian torsion. Two patients with pelvic abscesses not related to appendicitis underwent percutaneous drainage. Fourteen patients were treated medically. Dilated thick-walled appendix and periappendiceal inflammation were detected in three (75%) of four patients with acute appendicitis. In one patient with appendicitis, the appendix could not be visualized, but inflammation was present in the right lower quadrant. In three patients with ovarian torsion, MR imaging demonstrated right adnexal mass or inflammation. MR imaging was used to correctly identify pelvic abscesses and healthy appendix in two patients. A healthy appendix was depicted in 17 (89.5%) of 19 patients without acute appendicitis.
CONCLUSION: MR imaging shows promise for evaluation of pregnant women in whom acute appendicitis is suspected by enabling diagnosis of other possible causes of right-lower-quadrant pain, including ovarian torsion or pelvic abscesses, and demonstrating a healthy or unhealthy appendix. (c) RSNA, 2004.

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Year:  2004        PMID: 15591434     DOI: 10.1148/radiol.2341032002

Source DB:  PubMed          Journal:  Radiology        ISSN: 0033-8419            Impact factor:   11.105


  13 in total

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2.  [Surgery during pregnancy].

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Authors:  Paul Nikolaidis; Nancy Hammond; Jamie Marko; Frank H Miller; Nicholas Papanicolaou; Vahid Yaghmai
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Journal:  Emerg Radiol       Date:  2007-04-04

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6.  MRI of suspected appendicitis during pregnancy: interradiologist agreement, indeterminate interpretation and the meaning of non-visualization of the appendix.

Authors:  Richard Tsai; Constantine Raptis; Kathryn J Fowler; Joseph W Owen; Vincent M Mellnick
Journal:  Br J Radiol       Date:  2017-09-04       Impact factor: 3.039

7.  An evaluation of a superfast MRI sequence in the diagnosis of suspected acute appendicitis.

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Journal:  Quant Imaging Med Surg       Date:  2012-12

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

Authors:  Lodewijk Cobben; Ingrid Groot; Lucas Kingma; Emile Coerkamp; Julien Puylaert; Johan Blickman
Journal:  Eur Radiol       Date:  2009-01-10       Impact factor: 5.315

9.  Emergency MRI of acute pelvic pain: MR protocol with no oral contrast.

Authors:  Ajay K Singh; Hemali Desai; Robert A Novelline
Journal:  Emerg Radiol       Date:  2008-07-23

10.  Diagnostic accuracy and patient acceptance of MRI in children with suspected appendicitis.

Authors:  Mai E Thieme; Marjolein M N Leeuwenburgh; Zaldy D Valdehueza; Donald E Bouman; Ivar G J M de Bruin; W Hermien Schreurs; Alexander P J Houdijk; Jaap Stoker; Bart M Wiarda
Journal:  Eur Radiol       Date:  2013-10-19       Impact factor: 5.315

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