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KMID : 1103720080580020133
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Journal of the Korean Society of Radiology
2008 Volume.58 No. 2 p.133 ~ p.139
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The Efficacy of Unenhanced MR Imaging for the Diagnosis of Acute Appendicitis: A Performance Comparison Versus Abdominal Ultrasonography
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Seok Ji-Eun
Jang Hyun-Joo
Lee Jin
Yoon Dae-Kun
Lee Jae-Jung
Lee Kyung-Kyu
Hwang Dae-Hyun
Cho Seong-Whi
Min Seon-Jeong
Kang Ik-Won
Lee Il-Seung
Choi Chul-Soon
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Abstract
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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.
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KEYWORD
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Appendicitis, Appendix, Magnetic resonance(MR), Acute diseases
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