J Korean Radiol Soc.  2008 Feb;58(2):133-139. 10.3348/jkrs.2008.58.2.133.

The Efficacy of Unenhanced MR Imaging for the Diagnosis of Acute Appendicitis: A Performance Comparison Versus Abdominal Ultrasonography

• Seok JE
• Min SJ
• Cho SW
• Kang IW
• Hwang DH
• Lee ES
• Lee GK
• Lee JJ
• Yoon DK
• Lee J
• Jang HJ
• Choi CS

• KMID: 2209116
• DOI: http://doi.org/10.3348/jkrs.2008.58.2.133

Abstract

PURPOSE: To evaluate the efficacy of unenhanced MR imaging compared to the diagnostic accuracy, advantage, and limitations of abdominal ultrasonography in the diagnosis of acute appendicitis.
MATERIALS AND METHODS
The study included 40 patients suspected of having acute appendicitis and who were subjected to an unenhanced MR image, as well as an abdominal ultrasonography. A T1 FLASH in an axial image, a chemical shift-selective fat suppressed T2 HASTE in an axial image, as well as a T2 HASTE in an axial and coronal image were obtained as unenhanced MR images. The diagnosis was established based on a surgical or clinical follow-up of the unenhanced MR results, which were then statistically compared to the ultrasonographic results.
RESULTS
The surgical or clinical follow-up results revealed that 25 patients were positively diagnosed with appendicitis. Of these, 7 patients had symptoms of acute appendicitis with no pathologic diagnoses, whereas the 8 remaining patients were diagnosed with another condition. The sensitivity and accuracy of the unenhanced MR imaging was 92% and 90%, compared to ultrasonography which was 68% and 72.5% accurate, respectively. The differences in sensitivity and accuracy between the two methods were found to be statistically significant (p < .05, chi-square test). Based on these results, unenhanced MR imaging was superior to sonography for the diagnosis of appendicitis.
CONCLUSION
Unenhanced MR imaging may be a useful modality for the diagnosis of acute appendicitis, especially for suboptimal or nondiagnostic sonographies, as well as patients that are particularly sensitive to radiation exposure.

Keyword

Appendicitis; Appendix; Magnetic resonance (MR); Acute diseases

MeSH Terms

Acute Disease
Appendicitis
Appendix
Follow-Up Studies
Humans
Imidazoles
Nitro Compounds
Imidazoles
Nitro Compounds