Aims: To assess the performance of magnetic resonance ımaging (MRI ) scale for the diagnosis of acute appendicitis in pregnant women and to determine the added diagnostic value of MRI imaging.
Methods: In this retrospective study, the data of patients who presented to our hospital emergency department between January 2018 and December 2021, had clinical and laboratory findings consistent with acute appendicitis, and were diagnosed with radiological imaging, were extracted from the hospital automation system and used for statistical analysis. Ultrasound (US) was used as the first-line diagnostic method for pregnant patients, and magnetic resonance imaging (MRI) was used as the second-line diagnostic method. The success of US and MRI examinations in diagnosing acute appendicitis was evaluated. In MRI examinations, the mean values of appendix diameter and wall thickness parameters were examined, and the sensitivity, specificity, positive predictive value, and negative predictive value of periappendiceal fat tissue intensity increase, T2A lumen hyperintensity, and periappendiceal fluid parameters were evaluated. Additionally, the frequency of acute appendicitis according to trimesters was examined. SPSS v20.0 (IBM SPSS Statistics for Windows, Version 20.0; Armonk, NY, USA) package program was used for the analysis.
Results: When the medical records of 200 patients diagnosed with appandicitis were retrospectively examined, it was determined that there were 13 pregnant cases diagnosed with MRI during this period. Sensitivity, specificity, positive predictive value, and negative predictive value were evaluated for parameters including intraluminal T2A hyperintensity, wall thickness, periappendiceal fluid accumulation, and periappendiceal fatty tissue intensity increase. İntraluminal T2A hyperintensity and also periappendiceal fatty tissue intensity increase parameter sensitivity was 100%, however the wall thickness parameter had a sensitivity of 60% and the periappendiceal fluid accumulation parameter had a sensitivity of 80%. the periappendiceal fatty tissue intensity increase parameter had a a specificity of 33.3%, which is the lowest ratio among the other parameters. there was also no significant difference in the frequency of acute appendicitis according to trimesters
Conclusion: MRI examination has a high success rate and can be used as the primary diagnostic method for pregnant appandicitis cases. In terms of parameter evaluation, the highest positive predictive value (90.9%) is found by the parameter of intraluminal T2 hyperintensity, and the parameter of periappendiceal fluid collection is found to be in the second place. The success of T2A lumen hyperintensity and periappendiceal fat tissue intensity increase parameters, especially in excluding negative cases, was found to be quite high.
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Primary Language | English |
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Subjects | Radiology and Organ Imaging |
Journal Section | Original Article |
Authors | |
Early Pub Date | October 28, 2023 |
Publication Date | October 29, 2023 |
Published in Issue | Year 2023 Volume: 6 Issue: 6 |
Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS].
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Editor List for 2022
Assoc. Prof. Alpaslan TANOĞLU (MD)
Prof. Aydın ÇİFCİ (MD)
Prof. İbrahim Celalaettin HAZNEDAROĞLU (MD)
Prof. Murat KEKİLLİ (MD)
Prof. Yavuz BEYAZIT (MD)
Prof. Ekrem ÜNAL (MD)
Prof. Ahmet EKEN (MD)
Assoc. Prof. Ercan YUVANÇ (MD)
Assoc. Prof. Bekir UÇAN (MD)
Assoc. Prof. Mehmet Sinan DAL (MD)
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