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Optimisation of the MR protocol in pregnant women with suspected acute appendicitis

 Ilah Shin  ;  Yong Eun Chung  ;  Chansik An  ;  Hye Sun Lee  ;  Honsoul Kim  ;  Joon Seok Lim  ;  Myeong-Jin Kim 
 European Radiology, Vol.28(2) : 514-521, 2018 
Journal Title
 European Radiology 
Issue Date
Acute Disease ; Adult ; Appendicitis/*diagnosis ; Appendix/*pathology ; Differential Diagnosis ; Female ; Humans ; Magnetic Resonance Imaging/*methods ; Pregnancy ; Pregnancy Complications/*diagnosis ; Prenatal Diagnosis/*methods ; Reproducibility of Results ; Young Adult
Abdomen ; Abdominal pain ; Acute ; Appendicitis ; Magnetic resonance imaging ; Pregnancy
PURPOSE: To investigate the optimal magnetic resonance (MR) imaging protocol in pregnant women suspected of having acute appendicitis. MATERIALS AND METHODS: One hundred and forty-six pregnant women with suspected appendicitis were included. MR images were reviewed by two radiologists in three separate sessions. In session 1, only axial single-shot turbo spin echo (SSH-TSE) T2-weighted images (WI) were included with other routine sequences. In sessions 2 and 3, coronal and sagittal T2WI were sequentially added. The visibility of the appendix and diagnostic confidence of appendicitis were evaluated in each session using a 5-point grading scale. If diseases other than appendicitis were suspected, specific diagnosis with a 5-point confidence scale was recorded. Diagnostic performance for appendicitis and other diseases were evaluated. RESULTS: Twenty-five patients (17.1%) were diagnosed with appendicitis. Among the patients with normal appendix, 28 were diagnosed with other disease. Diagnostic performance including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve values for diagnosing appendicitis and other diseases showed no significant difference among sets for both reviewers (p>0.05). CONCLUSION: Diagnostic performance of MR in pregnant patients with suspected appendicitis can be preserved with omission of sagittal or both coronal and sagittal SSH-T2WI. KEY POINTS: * Diagnostic performance of appendicitis is preserved with omission of sagittal/coronal T2WIs. * Diagnosis of other disease may be sufficient with axial T2WIs only. * Careful serial omission of sagittal and coronal T2WIs can be considered.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
김명진(Kim, Myeong Jin) ORCID logo https://orcid.org/0000-0001-7949-5402
김한솔(Kim, Hon Soul)
안찬식(An, Chansik) ORCID logo https://orcid.org/0000-0002-0484-6658
이혜선(Lee, Hye Sun) ORCID logo https://orcid.org/0000-0001-6328-6948
임준석(Lim, Joon Seok) ORCID logo https://orcid.org/0000-0002-0334-5042
정용은(Chung, Yong Eun) ORCID logo https://orcid.org/0000-0003-0811-9578
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