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Diagnostic accuracy of magnetic resonance imaging for acute appendicitis during pregnancy: A systematic review

Sung Uk Cho1, Se Kwang Oh1

  • 1Department of Emergency Medicine, Chungnam National University Hospital, Daejeon-South Korea.

Ulusal Travma Ve Acil Cerrahi Dergisi = Turkish Journal of Trauma & Emergency Surgery : TJTES
|April 22, 2021
PubMed
Abstract

Insights

Magnetic resonance imaging (MRI) demonstrates high accuracy in diagnosing acute appendicitis in pregnant women. This systematic review confirms MRI as a valuable first-line imaging tool for suspected appendicitis during pregnancy.

Area of Science:

  • Medical imaging
  • Diagnostic accuracy
  • Obstetrics and Gynecology

Background:

  • Acute appendicitis is a common surgical emergency in pregnancy.
  • Diagnostic challenges exist due to anatomical and physiological changes during pregnancy.
  • Accurate and timely diagnosis is crucial for maternal and fetal well-being.

Purpose of the Study:

  • To systematically review and meta-analyze the diagnostic accuracy of MRI for acute appendicitis in pregnant women.
  • To evaluate MRI's effectiveness as a diagnostic tool in this specific population.
  • To provide evidence-based recommendations for imaging protocols.

Main Methods:

  • Comprehensive literature search across major databases (PubMed, Ovid MEDLINE, EMBASE, Cochrane Library).
  • Inclusion of studies using MRI for acute appendicitis diagnosis in pregnant women with available diagnostic parameters.
  • Extraction of demographic data and diagnostic accuracy measures (sensitivity, specificity, PPV, NPV).
  • Generation of Forest plots and summary receiver operating characteristic (SROC) curves.

Main Results:

  • Analysis of 22 studies involving 2392 patients.
  • Most studies reported high sensitivity and specificity (close to 1.0, lowest 0.92).
  • Summary receiver operating characteristic (SROC) curves indicated high diagnostic accuracy with an area under the curve (AUC) of 0.9922.

Conclusions:

  • Magnetic resonance imaging (MRI) exhibits high overall accuracy for diagnosing acute appendicitis in pregnant women.
  • MRI is a reliable and effective first-line imaging modality for suspected appendicitis in pregnancy.
  • The findings support the integration of MRI into standard diagnostic pathways for pregnant patients.

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