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

Am J Obstet Gynecol. 2015 Nov;213(5):693.e1-6. doi: 10.1016/j.ajog.2015.07.026. Epub 2015 Jul 26.

Abstract

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.

Keywords: appendicitis; magnetic resonance imaging; pregnancy.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Appendicitis / diagnosis*
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Middle Aged
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Young Adult