MRI excellent imaging option for diagnosing acute appendicitis in pregnant women
Magnetic resonance imaging (MRI) offers high specificity and sensitivity for the diagnosis of acute appendicitis in pregnant women, revealed a study published in the World Journal of Emergency Surgery.
The incidence rate of acute appendicitis in pregnancy has been reported to be 1:1250 and 1:1500. The possibility of acute appendicitis is higher in the second and third decades of life which are the fertility years. Therefore, proper diagnosis of appendicitis is crucial to prevent complications during pregnancy. Magnetic resonance imaging was introduced by the American College of Radiology as a recommended diagnostic test.
To analyze the efficacy of MRI to detect appendicitis in pregnant women researchers from Zabol University of Medical Sciences conducted a systematic review and meta-analysis which included relevant studies published from 1/1/2009 until end of 30/12/2018. They searched for published literature in the English language in MEDLINE via PubMed, EMBASETM via Ovid, The Cochrane Library, and Trip database. For literature published in other languages, we searched national databases (Magiran and SID), KoreaMed, and LILACS.
The keywords used in the search strategy are Pregnancy [MeSH], Pregnant [MeSH] OR—Magnetic resonance imaging [MeSH] OR—Appendicitis [MeSH] OR—Ultrasound, [MeSH] OR, imaging, MRI [MeSH] OR"،" and Right lower quadrant pain [MeSH]. The risk of bias of every article was evaluated by using QUADAS-2. On the basis of the results from the 2 × 2 tables, pooled measures for sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curves (AUC) along with their 95% confidence intervals (CIs) were calculated using the DerSimonian Lair methodology.
- As many as 1164 studies were selected from the meta-analysis.
- After analyzing the correspondence of the studies with the required criteria, 19 studies were selected for the final review.
- For appendicitis in pregnancy, the Magnetic resonance imaging sensitivity was 91.8% at the 95% confidence interval of.
- At the confidence interval of 95%, the specificity was 97.9%.
- The risk of bias in the studies conducted was measured using the QUADAS-2 tool.
"Magnetic resonance imaging has high sensitivity and specificity (91.8%, 97.9% respectively) for the diagnosis of acute appendicitis in pregnant patients with clinically suspected appendicitis. It is an excellent imaging technique in many instances, which does not expose a fetus, or the mother, to ionizing radiation, making it an excellent option for pregnant patients with suspected acute appendicitis." concluded the authors.
For further reference, click on the link below