Related Experiment Video
Updated: Apr 16, 2026
Whole-body PET/MRI of Pediatric Patients: The Details That Matter
Published on: December 19, 2017
An implemented MRI program to eliminate radiation from the evaluation of pediatric appendicitis
Afif N Kulaylat1, Michael M Moore2, Brett W Engbrecht1
1Division of Pediatric Surgery, Department of Surgery, The Pennsylvania State University, College of Medicine, 500 University Drive, Hershey, PA 17033-0850, USA.
Background:
Recent efforts have been directed at reducing ionizing radiation delivered by CT scans to children in the evaluation of appendicitis. MRI has emerged as an alternative diagnostic modality. The clinical outcomes associated with MRI in this setting are not well-described.
Methods:
Review of a 30-month institutional experience with MRI as the primary diagnostic evaluation for suspected appendicitis (n=510). No intravenous contrast, oral contrast, or sedation was administered. Radiologic and clinical outcomes were abstracted.
Results:
MRI diagnostic characteristics were: sensitivity 96.8% (95% CI: 92.1%-99.1%), specificity 97.4% (95% CI: 95.3-98.7), positive predictive value 92.4% (95% CI: 86.5-96.3), and negative predictive value 98.9% (95% CI: 97.3%-99.7%). Radiologic time parameters included: median time from request to scan, 71 minutes (IQR: 51-102), imaging duration, 11 minutes (IQR: 8-17), and request to interpretation, 2.0 hours (IQR: 1.6-2.6). Clinical time parameters included: median time from initial assessment to admit order, 4.1 hours (IQR: 3.1-5.1), assessment to antibiotic administration 4.7 hours (IQR: 3.9-6.7), and assessment to operating room 9.1 hours (IQR: 5.8-12.7). Median length of stay was 1.2 days (range: 0.2-19.5).
Conclusion:
Given the diagnostic accuracy and favorable clinical outcomes, without the potential risks of ionizing radiation, MRI may supplant the role of CT scans in pediatric appendicitis imaging.
Insights
Magnetic resonance imaging (MRI) offers high accuracy for diagnosing appendicitis in children, showing favorable clinical outcomes without radiation. This makes MRI a potential replacement for CT scans in pediatric appendicitis evaluation.
Area of Science:
- Pediatric radiology
- Diagnostic imaging
- Medical imaging techniques
Background:
- Efforts to reduce ionizing radiation from CT scans in pediatric appendicitis evaluation.
- MRI is an emerging alternative diagnostic modality.
- Limited data exists on clinical outcomes of MRI for appendicitis in children.
Purpose of the Study:
- To evaluate the diagnostic accuracy and clinical outcomes of MRI as a primary imaging tool for suspected appendicitis in children.
- To compare MRI performance against CT scans in terms of radiation exposure and clinical results.
Main Methods:
- A retrospective review of 510 pediatric patients who underwent MRI for suspected appendicitis.
- No contrast, sedation, or oral contrast agents were used.
- Radiologic and clinical outcomes were analyzed.
Main Results:
- MRI demonstrated high diagnostic accuracy: 96.8% sensitivity, 97.4% specificity.
- Favorable clinical outcomes were observed, with a median length of stay of 1.2 days.
- Efficient imaging and interpretation times were noted, with median request-to-interpretation at 2.0 hours.
Conclusions:
- MRI is a highly accurate imaging modality for pediatric appendicitis.
- It offers favorable clinical outcomes without the risks of ionizing radiation.
- MRI may replace CT scans as the preferred imaging method for pediatric appendicitis.
Related Concept Videos
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
01:27Imaging Studies IV: Magnetic Resonance Imaging
01:24Magnetic Resonance Imaging
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:30Radiological Investigation I: X-ray and CT
01:30Radiological Investigation II: MRI and Ventilation Perfusion Scan
Magnetic Resonance Imaging (MRI) and Ventilation Perfusion Scans are two radiological investigations that offer detailed diagnostic images of the body, particularly lung structures.
MRI
MRI uses magnetic fields and radiofrequency signals to distinguish between normal and abnormal tissues. This technology provides a more detailed diagnostic image than CT scans, enabling it to characterize pulmonary nodules, stage bronchogenic carcinoma, and evaluate inflammatory activity in...