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

Jeong Rye Kim1, Chong Hyun Suh2, Hee Mang Yoon1

  • 1Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Journal of Magnetic Resonance Imaging : JMRI
|August 18, 2017
PubMed
Abstract

Insights

Magnetic resonance imaging (MRI) demonstrates high accuracy in diagnosing appendicitis in children. Non-contrast MRI may be sufficient, reducing the need for contrast agents and improving patient care.

Area of Science:

  • Radiology
  • Pediatric Imaging
  • Diagnostic Accuracy

Background:

  • Appendicitis is a common surgical emergency in children.
  • Accurate diagnosis is crucial to avoid unnecessary surgery (negative appendectomy).
  • Magnetic resonance imaging (MRI) is increasingly used for suspected appendicitis in pediatric patients.

Purpose of the Study:

  • To evaluate the diagnostic performance of MRI for suspected appendicitis in pediatric patients.
  • To determine the negative appendectomy rate associated with MRI use.
  • To assess factors influencing MRI accuracy in this population.

Main Methods:

  • Systematic review and meta-analysis of diagnostic accuracy studies.
  • Inclusion of studies using MRI for pediatric appendicitis diagnosis.
  • Assessment of methodological quality using the QUADAS-2 tool.
  • Calculation of pooled sensitivity, specificity, and negative appendectomy rate.
  • Meta-regression to explore heterogeneity.

Main Results:

  • 13 studies with 1946 patients were included.
  • Pooled sensitivity and specificity for appendicitis were 97%.
  • The hierarchical summary receiver operating characteristic (HSROC) curve area was 0.98.
  • The pooled negative appendectomy rate was 4.5%.
  • Diffusion-weighted imaging and patient age influenced heterogeneity.

Conclusions:

  • MRI exhibits excellent diagnostic performance for pediatric appendicitis.
  • Non-enhanced MRI protocols may be suitable for suspected appendicitis in children.
  • MRI can effectively reduce negative appendectomy rates.
Keywords:
MRIappendicitischildrenmagnetic resonance imaging

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