MRI keeps up with CT in diagnosing acute appendicitis
A team of Wisconsin researchers found MRI's accuracy similar to that of CT in diagnosing acute appendicitis, according to a recent Radiology study.
The American College of Radiology recommends CT in most cases, aside from pregnant and pediatric patients, due to its diagnostic accuracy. But radiation exposure has become a concern, leading many to champion the use of MRI or ultrasound.
In this study, the authors analyzed images of 198 patients—all of whom were not pregnant and at least 12 years or older when they underwent both CT and MRI scans.
The likelihood of appendicitis was graded on a five-point scale, with five signaling “definitely” for the condition. In a cutoff of three or higher, MRI achieved 96.9 percent sensitivity and 81.3 percent specificity. In CT, sensitivity was measured at 98.4 percent and specificity of 89.6 percent.
“We conclude that MR imaging may be a suitable alternative for the evaluation of acute appendicitis when MR imaging availability and expertise exist, particularly in patients who are not expected to require sedation,” wrote corresponding author Michael D., Repplinger, MD, PhD, with the departments of emergency medicine and radiology at the University of Wisconsin in Madison, and colleagues. "[W]e propose that intravenous contrast-enhanced MR imaging may be a viable initial imaging option for the evaluation of appendicitis in the ED in nonpregnant patients.”
The authors cited a number of limitations for the study, including a relatively small number of enrolled patients, which led to a younger study population and higher prevalence of appendicitis, and the fact that the research was conducted at a single academic medical center.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.