caa a22 4500 605494827 CHVBK 20210128100528.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00261-015-0540-7 doi (NATIONALLICENCE)springer-10.1007/s00261-015-0540-7 MRI: first-line imaging modality for pregnant patients with suspected appendicitis [Elektronische Daten] [Joseph Konrad, David Grand, Ana Lourenco] Purpose: The purpose of our study was to evaluate the sensitivity, specificity, and accuracy of ultrasound (US) as compared to magnetic resonance imaging (MRI) in pregnant patients with suspected appendicitis for visualization of the appendix, accuracy at diagnosing acute appendicitis, the ability of each modality to identify alternate diagnoses of pain and whether gestational age (GA) has an association with appendix identification rates. Methods: We retrospectively reviewed the records of 140 pregnant patients with suspected appendicitis to determine the efficacy of US and MRI to identify the appendix, diagnose or exclude acute appendicitis, identify alternative etiologies for clinical presentation, and the affect of GA on identification of the appendix. Imaging results were correlated with surgical pathology in patients who underwent surgery. The electronic medical record was used to assess clinical outcomes in patients who did not undergo surgery. Results: The appendix was visualized in 7% (8/117) of US exams and in 80% (91/114) of MRI exams. Alternate etiologies of pathology were determined in 3% (3/117) of US exams and 12% (14/114) of MRI exams. The sensitivity and specificity of MRI for acute appendicitis were both 100% and 98%, respectively, as compared to 18% and 99%, respectively, with US. GA did not affect MRI or ultrasound visualization rates of the appendix. Conclusion: Given the low likelihood of visualization of the appendix at US, the excellent accuracy of MRI and the ability of MRI to identify alternate diagnoses, we suggest that at certain institutions MRI may be considered a first-line imaging modality for pregnant patients of any GA with suspected appendicitis. Springer Science+Business Media New York, 2015 Pregnant nationallicence Magnetic resonance imaging nationallicence Appendicitis nationallicence Ultrasound nationallicence Konrad Joseph Department of Diagnostic Imaging, Rhode Island Hospital, Brown University, 593 Eddy Street, 02903, Providence, RI, USA aut Grand David Department of Diagnostic Imaging, Rhode Island Hospital, Brown University, 593 Eddy Street, 02903, Providence, RI, USA aut Lourenco Ana Department of Diagnostic Imaging, Rhode Island Hospital, Brown University, 593 Eddy Street, 02903, Providence, RI, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/8(2015-10-01), 3359-3364 0942-8925 40:8<3359 2015 40 261 https://doi.org/10.1007/s00261-015-0540-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-015-0540-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Konrad Joseph Department of Diagnostic Imaging, Rhode Island Hospital, Brown University, 593 Eddy Street, 02903, Providence, RI, USA aut NATIONALLICENCE 700 1- Grand David Department of Diagnostic Imaging, Rhode Island Hospital, Brown University, 593 Eddy Street, 02903, Providence, RI, USA aut NATIONALLICENCE 700 1- Lourenco Ana Department of Diagnostic Imaging, Rhode Island Hospital, Brown University, 593 Eddy Street, 02903, Providence, RI, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/8(2015-10-01), 3359-3364 0942-8925 40:8<3359 2015 40 261