Learning objectives
To reveal the value and potential role of MR imaging in the evaluation of patients suspected of having acute appendicitis.
To get familiar with and to be able to recognize the typical MRI findings seen in acute appendicitis.
Background
Acute appendicitis is frequently seen in the emergency department and in most cases,
surgical treatment is needed.
To prevent unnecessary complications and delays in diagnosis,
a fast and efficient imaging must be performed,
with US and in addition CT being the first line modalities.
However,
in the latest years,
MRI is proving to be an equal or even better tool in the diagnosis of appendicitis.
Over the last decades,
MRI machines have been improved to maximize their efficiency,
safety,
speed,
imaging quality and overall performance....
Findings and procedure details
MRI PROTOCOLS FOR ACUTE APPENDICITIS
In recent literature,
many scanning protocols have been described.
They usually differ only by minor changes,
such as the addition of some specific sequences,
use of different fat suppression methods or use of a different amount of scanning planes.
Regardless the differences,
they all have a quite similar structure,
which represents the backbone of this protocol.
The main scanning protocol for acute appendicitis usually includes:
T1–weighted images in axial plane
T2–weighted imaging with single-shot fast spin echo (HASTE,
SSFSE) in...
Conclusion
MRI is a multi-planar,
systemic and high-resolution imaging modality,
which allows a better insight in the abdominal cavity compared to CT and US.
With an excellent overall performance,
MRI is a feasible alternative in diagnosing acute appendicitis in the adult and pediatric population.
Personal information
Contact details:
Ingrid Požar,
MD
Resident in training.
Department of Radiology,
Izola General Hospital,
Polje 40,
6310 Izola,
Slovenia.
Institute of Radiology,
University Medical Centre Ljubljana,
Zaloška cesta 2,
1000 Ljubljana,
Slovenia.
Email:
[email protected]
Ksenija Vidmar Kocijančič,
MD,
PhD
Department of Radiology,
Izola General Hospital,
Polje 40,
6310 Izola,
Slovenia.
Email:
[email protected]
References
Patel D,
Fingard J,
Winters S,
Low G.
Clinical use of MRI for the evaluation of acute appendicitis during pregnancy.
Abdom Radiol.
2017;42(7):1857–63.
Kim JR,
Suh CH,
Yoon HM,
Jung AY,
Lee JS,
Kim JH,
et al.
Performance of MRI for suspected appendicitis in pediatric patients and negative appendectomy rate: A systematic review and meta-analysis.
J Magn Reson Imaging.
2017 Aug 17.
doi: 10.1002/jmri.25825.
[Epub ahead of print]
Duke E,
Kalb B,
Arif-Tiwari H,
Daye ZJ,
Gilbertson-Dahdal D,
Keim SM,
et al.
A systematic review...