Diagnostic performance of diffusion-weighted MR imaging in detecting acute appendicitis in children: Comparison with conventional MRI and surgical findings

• Published in: Journal of magnetic resonance imaging 2014-06, Vol.39 (6), p.1518-1524
• Main Authors: Bayraktutan, Ümmugulsum, Oral, Akgün, Kantarci, Mecit, Demir, Muhammet, Ogul, Hayri, Yalcin, Ahmet, Kaya, Idris, Salman, Ahmet Bedii, Yiğiter, Murat, Okur, Adnan
• Format: Article
• Language: English
• Subjects: acute appendicitis; Acute Disease; Adolescent; Appendicitis - diagnosis; Appendicitis - surgery; Appendix - pathology; Appendix - surgery; Child; Child, Preschool; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging - methods; diffusion-weighted imaging; Female; Humans; Image Processing, Computer-Assisted - methods; Infant; Infant, Newborn; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; MRI; Observer Variation; Prospective Studies; Reproducibility of Results; Sensitivity and Specificity
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.24316

Purpose To determine the value of diffusion‐weighted MRI for the diagnosis of acute appendicitis in children. Materials and Methods Forty‐five consecutive patients with a clinical diagnosis of acute appendicitis underwent abdominal MRI; 39 were operated on for acute appendicitis. First, the diffusion‐weighted imaging (DWI) alone was reviewed, followed by conventional MRI alone, and then conventional MRI and DWI were reviewed by two observers within a consensus. The surgical findings were compared with the MRI. Sensitivity, specificity, and accuracy were calculated for DWI, conventional MRI, and combined DWI and conventional MRI for the depiction of acute appendicitis. Results A combination of DWI and conventional MRI was the most sensitive and the most accurate, with corresponding sensitivity and accuracy of 0.92 and 0.92, respectively. Using DWI alone the sensitivity and accuracy was found to be 0.78 and 0.77, respectively. Using conventional MRI alone, sensitivity of 0.81 and accuracy of 0.82 was found for the consensus of the two observers. Conclusion The use of combination of DWI and conventional MRI is a valuable technique in the diagnosis of acute appendicitis in children. J. Magn. Reson. Imaging 2014;39:1518–1524. © 2013 Wiley Periodicals, Inc.