Performance of MRI for suspected appendicitis in pediatric patients and negative appendectomy rate: A systematic review and meta‐analysis

Purpose To evaluate in pediatric patients the diagnostic performance of magnetic resonance imaging (MRI) for suspected appendicitis and its negative appendectomy rate. Materials and Methods The study involved diagnostic accuracy studies that used MRI for pediatric patients with suspected appendiciti...

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Bibliographic Details
Published in:Journal of magnetic resonance imaging 2018-03, Vol.47 (3), p.767-778
Main Authors: Kim, Jeong Rye, Suh, Chong Hyun, Yoon, Hee Mang, Jung, Ah Young, Lee, Jin Seong, Kim, Jung Heon, Lee, Jeong‐Yong, Cho, Young Ah
Format: Article
Language:English
Subjects:
Accuracy
Appendectomy
Appendicitis
children
Confidence intervals
Contrast media
Diagnostic software
Diagnostic systems
Heterogeneity
Intravenous administration
Magnetic resonance imaging
Meta-analysis
MRI
NMR
Nuclear magnetic resonance
Patients
Pediatrics
Quality assessment
Quality control
Regression analysis
Sensitivity
Sensitivity analysis
Statistical analysis
Systematic review
Ultrasonic imaging
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Summary:Purpose To evaluate in pediatric patients the diagnostic performance of magnetic resonance imaging (MRI) for suspected appendicitis and its negative appendectomy rate. Materials and Methods The study involved diagnostic accuracy studies that used MRI for pediatric patients with suspected appendicitis. Various field strengths and sequences were used in each included study. The diagnostic accuracy of MRI in pediatric patients with suspected appendicitis and negative appendectomy rate were assessed. A search of MEDLINE and EMBASE databases was performed until January 10, 2017. Two reviewers assessed the methodological quality of the articles using the Quality Assessment of Diagnostic Accuracy Studies‐2 (QUADAS‐2) tool. Pooled sensitivity and specificity for appendicitis diagnosis were calculated using hierarchical logistic regression modeling. Meta‐regression was performed to explore factors affecting study heterogeneity. The pooled negative appendectomy rate was analyzed. Results Thirteen original articles with 1946 patients were included. The summary sensitivity and specificity were 97% (95% confidence interval [CI], 95–98%) and 97% (95% CI, 93–98%), respectively; the area under the hierarchical summary receiver operating characteristic (HSROC) curve was 0.98 (95% CI, 0.97–0.99). In meta‐regression, use of diffusion‐weighted imaging (P 
ISSN:1053-1807
1522-2586
DOI:10.1002/jmri.25825