MRI features associated with acute appendicitis

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• 作者：Marjolein M. N. Leeuwenburgh (1) (10) (2)
  Sebastiaan Jensch (3)
  Jan W. C. Gratama (4)
  Aart Spilt (5)
  Bart M. Wiarda (6)
  H. Wouter Van Es (7)
  Lodewijk P. J. Cobben (8)
  Patrick M. M. Bossuyt (9)
  Marja A. Boermeester (1)
  Jaap Stoker (2)
  
• 关键词：Magnetic resonance imaging ; Appendicitis ; Sensitivity and specificity ; Abdominal pain
• 刊名：European Radiology
• 出版年：2014
• 出版时间：January 2014
• 年：2014
• 卷：24
• 期：1
• 页码：214-222
• 全文大小：
• 作者单位：Marjolein M. N. Leeuwenburgh (1) (10) (2)
  Sebastiaan Jensch (3)
  Jan W. C. Gratama (4)
  Aart Spilt (5)
  Bart M. Wiarda (6)
  H. Wouter Van Es (7)
  Lodewijk P. J. Cobben (8)
  Patrick M. M. Bossuyt (9)
  Marja A. Boermeester (1)
  Jaap Stoker (2)
  
  1. Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  10. Department of Radiology (G1-223.1), Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
  2. Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  3. Department of Radiology, Sint Lucas Andreas Hospital, Amsterdam, The Netherlands
  4. Department of Radiology, Gelre Hospitals, Apeldoorn, The Netherlands
  5. Department of Radiology, Kennemer Gasthuis, Haarlem, The Netherlands
  6. Department of Radiology, Alkmaar Medical Center, Alkmaar, The Netherlands
  7. Department of Radiology, Sint Antonius Hospital, Nieuwegein, The Netherlands
  8. Department of Radiology, Haaglanden Medical Center, Leidschendam, The Netherlands
  9. Department of Clinical Epidemiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
  
• ISSN：1432-1084

文摘

Objectives To identify MRI features associated with appendicitis. Methods Features expected to be associated with appendicitis were recorded in consensus by two expert radiologists on 223 abdominal MRIs in patients with suspected appendicitis. Nine MRI features were studied: appendix diameter >7?mm, appendicolith, peri-appendiceal fat infiltration, peri-appendiceal fluid, absence of gas in the appendix, appendiceal wall destruction, restricted diffusion of the appendiceal wall, lumen or focal fluid collections. Appendicitis was assigned as the final diagnosis in 117/223 patients. Associations between imaging features and appendicitis were evaluated with logistic regression analysis. Results All investigated features were significantly associated with appendicitis in univariate analysis. Combinations of two and three features were associated with a probability of appendicitis of 88?% and 92?%, respectively. In patients without any of the nine features, appendicitis was present in 2?% of cases. After multivariate analysis, only an appendix diameter >7?mm, peri-appendiceal fat infiltration and restricted diffusion of the appendiceal wall were significantly associated with appendicitis. The probability of appendicitis was 96?% in their presence and 2?% in their absence. Conclusions An appendix diameter >7?mm, peri-appendiceal fat infiltration and restricted diffusion of the appendiceal wall have the strongest association with appendicitis on MRI. Key points ? An enlarged appendix, fat infiltration and restricted diffusion are associated with appendicitis. ? One such feature on MRI gives an 88?% probability of appendicitis. ? Two features in combination give a probability of appendicitis of 94?%. ? Combinations of three features give a probability of appendicitis of 96?%. ? The absence of these features almost rules out appendicitis (2?%).