Magnetic resonance imaging of acute appendicitis in pregnancy: a 5-year multiinstitutional study

Lauren M B Burke, Mustafa R Bashir, Frank H Miller, Evan S Siegelman, Michele Brown, Mamdoh Alobaidy, Tracy A Jaffe, Shahid M Hussain, Suzanne L Palmer, Bonnie L Garon, Aytekin Oto, Caroline Reinhold, Susan M Ascher, Danielle K Demulder, Stephen Thomas, Shaun Best, James Borer, Ken Zhao, Fanny Pinel-Giroux, Isabela De Oliveira, Daniel Resende, Richard C Semelka
American Journal of Obstetrics and Gynecology 2015, 213 (5): 693.e1-6

OBJECTIVE: The purpose of this study was to determine the diagnostic performance of magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis during pregnancy in a multiinstitutional study.

STUDY DESIGN: In this multicenter retrospective study, the cases of pregnant women who underwent MRI evaluation of abdominal or pelvic pain and who had clinical suspicion of acute appendicitis between June 1, 2009, and July 31, 2014, were reviewed. All MRI examinations with positive findings for acute appendicitis were confirmed with surgical pathologic information. Sensitivity, specificity, negative predictive values, and positive predictive values were calculated. Receiver operating characteristic curves were generated, and area under the curve analysis was performed for each participating institution.

RESULTS: Of the cases that were evaluated, 9.3% (66/709) had MRI findings of acute appendicitis. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive values were 96.8%, 99.2%, 99.0%, 92.4%, and 99.7%, respectively. There was no statistically significant difference between centers that were included in the study (pair-wise probability values ranged from 0.12-0.99).

CONCLUSION: MRI is useful and reproducible in the diagnosis of suspected acute appendicitis during pregnancy.

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