European Radiology: Specific MRI manifestations of acute appendicitis in children

Acute appendicitis is the most common clinical indication for
emergency abdominal surgery in children , and it must be distinguished from many non-surgical causes of abdominal pain .

Because the signs, symptoms, and laboratory tests of acute appendicitis in children are not specific, clinical diagnosis is still challenging

Acute appendicitis is the child of the most common emergency abdominal surgery child clinical indications, must be distinguished from the many causes of non-surgical abdominal area

For decades, US and CT have been the main imaging methods for suspected appendicitis in children

Recently, published in the E uropean a journal Radiology study to assess the independent application of MRI features assess the diagnostic performance of appendicitis in children, as existing pediatric appendicitis specific MRI diagnostic criteria provide a reference of correction and improvement .
 

This study evaluated unenhanced MRI images of suspected appendicitis in children from January 2014 to December 2017 .
A positive diagnosis is defined by surgical pathology or symptom relief after antibiotic treatment .
Four pediatric radiologists independently scored the study's biometrics while keeping the clinical data confidential .
A balanced complete block design is used to determine performance characteristics .
 antibiotic

The overall diagnosis of appendicitis (208 studies) has a sensitivity of 90.

6% and a specificity of 97.
7%

The overall diagnosis of appendicitis (208 studies) has a sensitivity of 90.

 

Figure a illustrates the relationship between the probability of a positive appendicitis (0 to 100%) and the diameter of the appendix (mm) .
The black data points represent actual positive and negative cases corresponding to the diameter of the appendix .
The solid black line is the slope, which represents the relationship between the diameter of the appendix and the possibility of appendicitis .
The light blue band is the 95% confidence band around the slope .
The red line represents the optimal threshold between the sensitivity and specificity of appendix diameter based on Youden's J index .
b Youden distribution shows the mathematically best distinction between positive and negative cases for each additional unit of appendix diameter .
At 7.
5 mm, the sensitivity is 89.
4% and the specificity is 86.
5% .
 

Figure a illustrates the relationship between the probability of a positive appendicitis (0 to 100%) and the diameter of the appendix (mm) .

The black data points represent actual positive and negative cases corresponding to the diameter of the appendix .
The solid black line is the slope, which represents the relationship between the diameter of the appendix and the possibility of appendicitis .
The light blue band is the 95% confidence band around the slope .
The red line represents the optimal threshold between the sensitivity and specificity of appendix diameter based on Youden's J index .
b Youden distribution shows the mathematically best distinction between positive and negative cases for each additional unit of appendix diameter .
At 7.
5 mm, the sensitivity is 89.

In summary, MRI assessment of children suspected of having appendicitis higher between sensitivity, specificity and the observer of consistency, also found most useful for identification of individual image features appendicitis comprising: a periphery (1) appendix lipedema The existence of (2) the diameter is greater than 7.
5 mm , (3) the ability to distinguish between the high-enhanced signal in the appendix lumen and the wall signal

Original source : Eric L Tung Grayson L Baird Rama S Ayyala ,et al 10.
1007/s00330-021-08120-4 10.
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