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MRI features associated with acute appendicitis

Marjolein M N Leeuwenburgh1, Sebastiaan Jensch, Jan W C Gratama

  • 1Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands, m.m.leeuwenburgh@amc.uva.nl.

European Radiology
|September 10, 2013
PubMed
Abstract

Insights

Magnetic Resonance Imaging (MRI) can identify key features of appendicitis. An enlarged appendix, fat infiltration, and restricted diffusion are strongly associated with appendicitis, aiding diagnosis.

Area of Science:

  • Radiology
  • Medical Imaging
  • Gastroenterology

Background:

  • Appendicitis diagnosis can be challenging.
  • MRI offers a non-invasive imaging modality for abdominal conditions.

Purpose of the Study:

  • To identify specific MRI features indicative of appendicitis.
  • To evaluate the diagnostic accuracy of these MRI features.

Main Methods:

  • Two expert radiologists reviewed 223 abdominal MRIs for suspected appendicitis.
  • Nine features were assessed: appendix diameter >7mm, appendicolith, fat infiltration, fluid, absence of gas, wall destruction, restricted diffusion, and focal collections.
  • Logistic regression analysis was used to correlate features with diagnosis.

Main Results:

  • Univariate analysis showed all nine features associated with appendicitis.
  • Multivariate analysis identified appendix diameter >7mm, peri-appendiceal fat infiltration, and restricted diffusion as significant indicators.
  • The presence of these three features yielded a 96% probability of appendicitis; absence yielded 2%.

Conclusions:

  • Appendix diameter >7mm, peri-appendiceal fat infiltration, and restricted diffusion are the strongest MRI predictors of appendicitis.
  • Combinations of these features significantly increase the probability of appendicitis.
  • The absence of these features effectively rules out appendicitis.

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