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A simple MRI protocol in patients with clinically suspected appendicitis: results in 138 patients and effect on outcome of appendectomy

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Abstract

To establish the value of breathhold magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis. Over a 14-month period, 138 patients clinically suspected of having appendicitis were evaluated prospectively with MRI and comprised the study group. Fast turbo spin-echo breathhold T1, T2 and T2 fat suppression sequences were used in coronal and axial planes. The imaging results were recorded separately and subsequently correlated with clinical, radiological and histopathological follow-up. The effect of imaging strategies in patients suspected of appendicitis on hospital resources was calculated. Sixty-two of the 138 patients had a histopathologically proven appendicitis. MRI determined appendicitis in 63 patients, with one examination being false positive. The resulting sensitivity and specificity were 100% and 99%, respectively. MRI showed an alternative diagnosis in 41 of the 75 remaining patients. In 22 of the remaining 34 patients, a normal appendix was depicted with MRI. In two patients, where MRI showed no appendicitis, an alternative diagnosis or normal appendix, an unnecessary appendectomy was performed. The overall effect of using MRI in patients suspected of appendicitis on the use of hospital resources could have been a net saving between € 55,746 and € 72,534. MRI has a high accuracy in detecting and excluding appendicitis, an alternative diagnosis or showing the normal appendix, and can be a valuable and cost-effective tool in the workup of patients clinically suspected of having appendicitis.

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Authors and Affiliations

  1. Department of Radiology, Medisch Centrum Haaglanden, Burgemeester Banninglaan 1, 2262BA, Leidschendam, The Netherlands

    Lodewijk Cobben

  2. Department of Surgery, Medisch Centrum Haaglanden, Burgemeester Banninglaan 1, 2262BA, Leidschendam, The Netherlands

    Ingrid Groot

  3. Department of Radiology, Medisch Centrum Haaglanden, Lijnbaan 32, 2501 CK, Den Haag, The Netherlands

    Lucas Kingma, Emile Coerkamp & Julien Puylaert

  4. Department of Radiology, Universitair Medisch Centrum St Radboud, Geert Grooteplein 10, 6525, GA, Nijmegen, The Netherlands

    Johan Blickman

Authors
  1. Lodewijk Cobben
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  2. Ingrid Groot
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  3. Lucas Kingma
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  4. Emile Coerkamp
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  5. Julien Puylaert
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  6. Johan Blickman
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Correspondence to Lodewijk Cobben.

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Cobben, L., Groot, I., Kingma, L. et al. A simple MRI protocol in patients with clinically suspected appendicitis: results in 138 patients and effect on outcome of appendectomy. Eur Radiol 19, 1175–1183 (2009). https://doi.org/10.1007/s00330-008-1270-9

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  • DOI: https://doi.org/10.1007/s00330-008-1270-9

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