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T1 bright appendix sign to exclude acute appendicitis in pregnant women

  • Emergency Radiology
  • Published:
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Abstract

Objective

To evaluate the diagnostic value of the T1 bright appendix sign for the diagnosis of acute appendicitis in pregnant women.

Material and methods

This retrospective study included 125 pregnant women with suspected appendicitis who underwent magnetic resonance (MR) imaging. The T1 bright appendix sign was defined as a high intensity signal filling more than half length of the appendix on T1-weighted imaging. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the T1 bright appendix sign for normal appendix identification were calculated in all patients and in those with borderline-sized appendices (6-7 mm).

Results

The T1 bright appendix sign was seen in 51% of patients with normal appendices, but only in 4.5% of patients with acute appendicitis. The overall sensitivity, specificity, PPV, and NPV of the T1 bright appendix sign for normal appendix diagnosis were 44.9%, 95.5%, 97.6%, and 30.0%, respectively. All four patients with borderline sized appendix with appendicitis showed negative T1 bright appendix sign.

Conclusion

The T1 bright appendix sign is a specific finding for the diagnosis of a normal appendix in pregnant women with suspected acute appendicitis.

Key Points

• Magnetic resonance imaging is increasingly used in emergency settings.

• Acute appendicitis is the most common cause of acute abdomen.

• Magnetic resonance imaging is widely used in pregnant population.

• T1 bright appendix sign can be a specific sign representing normal appendix.

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Abbreviations

MR:

Magnetic resonance

PPV:

Positive predictive value

NPV:

Negative predictive value

US:

Ultrasonography

CT:

Computed tomography

WBC:

White blood cell

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Authors and Affiliations

  1. Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Ilah Shin, Chansik An, Joon Seok Lim, Myeong-Jin Kim & Yong Eun Chung

Authors
  1. Ilah Shin
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  2. Chansik An
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  3. Joon Seok Lim
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  4. Myeong-Jin Kim
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  5. Yong Eun Chung
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Corresponding author

Correspondence to Yong Eun Chung.

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Guarantor

The scientific guarantor of this publication is Yong Eun, Chung.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Funding

This study has received funding by the Basic Science Research program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2014R1A1A2057091)

Statistics and biometry

No complex statistical methods were necessary for this paper.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Methodology

  • retrospective

  • observational

  • performed at one institution

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Shin, I., An, C., Lim, J.S. et al. T1 bright appendix sign to exclude acute appendicitis in pregnant women. Eur Radiol 27, 3310–3316 (2017). https://doi.org/10.1007/s00330-016-4727-2

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  • DOI: https://doi.org/10.1007/s00330-016-4727-2

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