Tiffany J Zens1, Andrew P Rogers1, Erica L Riedesel2, Charles M Leys1, Daniel J Ostlie3, Michael A Woods4, Kara G Gill5. 1. Division of Pediatric Surgery, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI; American Family Children's Hospital, University of Wisconsin Hospital and Clinics, Madison, WI. 2. Division of Pediatric Radiology, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI; American Family Children's Hospital, University of Wisconsin Hospital and Clinics, Madison, WI. 3. Phoenix Children's Hospital, Phoenix, AZ. 4. Division of Interventional Radiology, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI; American Family Children's Hospital, University of Wisconsin Hospital and Clinics, Madison, WI. 5. Division of Pediatric Radiology, Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI; American Family Children's Hospital, University of Wisconsin Hospital and Clinics, Madison, WI. Electronic address: kgill@uwhealth.org.
Abstract
INTRODUCTION: Contrast-enhanced CT remains the first-line imaging for evaluating postoperative abscess (POA) after appendicitis. Given concerns of ionizing radiation use in children, we began utilizing quick MRI to evaluate POA and summarize our findings in this study. MATERIALS AND METHODS: Children imaged with quick MRI from 2015 to 2017 were compared to children evaluated with CT from 2012 to 2014 using an age and weight matched case-control model. Radiation exposure, size and number of abscesses, length of exam, drain placement, and patient outcomes were compared. RESULTS: There was no difference in age or weight (p>0.60) between children evaluated with quick MRI (n=16) and CT (n=16). Mean imaging time was longer (18.2±8.5min) for MRI (p<0.001), but there was no difference in time from imaging order to drain placement (p=0.969). No children required sedation or had non-diagnostic imaging. There were no differences in abscess volume (p=0.346) or drain placement (p=0.332). Thirty-day follow-up showed no difference in readmissions (p=0.551) and no missed abscesses. Quick MRI reduced imaging charges to $1871 from $5650 with CT. CONCLUSION: Quick MRI demonstrated equivalent outcomes to CT in terms of POA detection, drain placement, and 30-day complications suggesting that MRI provides an equally effective, less expensive, and non-radiation modality for the identification of POA. TYPE OF STUDY: Retrospective Case-Control Study. LEVEL OF EVIDENCE: Level III. Published by Elsevier Inc.
INTRODUCTION: Contrast-enhanced CT remains the first-line imaging for evaluating postoperative abscess (POA) after appendicitis. Given concerns of ionizing radiation use in children, we began utilizing quick MRI to evaluate POA and summarize our findings in this study. MATERIALS AND METHODS:Children imaged with quick MRI from 2015 to 2017 were compared to children evaluated with CT from 2012 to 2014 using an age and weight matched case-control model. Radiation exposure, size and number of abscesses, length of exam, drain placement, and patient outcomes were compared. RESULTS: There was no difference in age or weight (p>0.60) between children evaluated with quick MRI (n=16) and CT (n=16). Mean imaging time was longer (18.2±8.5min) for MRI (p<0.001), but there was no difference in time from imaging order to drain placement (p=0.969). No children required sedation or had non-diagnostic imaging. There were no differences in abscess volume (p=0.346) or drain placement (p=0.332). Thirty-day follow-up showed no difference in readmissions (p=0.551) and no missed abscesses. Quick MRI reduced imaging charges to $1871 from $5650 with CT. CONCLUSION: Quick MRI demonstrated equivalent outcomes to CT in terms of POA detection, drain placement, and 30-day complications suggesting that MRI provides an equally effective, less expensive, and non-radiation modality for the identification of POA. TYPE OF STUDY: Retrospective Case-Control Study. LEVEL OF EVIDENCE: Level III. Published by Elsevier Inc.
Authors: Erica L Riedesel; Blake C Weber; Matthew W Shore; Randi S Cartmill; Daniel J Ostlie; Charles M Leys; Kara G Gill; Jonathan E Kohler Journal: Pediatr Radiol Date: 2019-07-24
Authors: Uli Fehrenbach; Timo A Auer; Wenzel Schöning; Moritz Schmelzle; Christian Jürgensen; Thomas Malinka; Marcus Bahra; Dominik Geisel; Timm Denecke Journal: Abdom Radiol (NY) Date: 2021-02-15