Abstract
References
- Segev L, Segev Y, Rayman S, et al. The diagnostic performance of ultrasound for acute appendicitis in pregnant and young nonpregnant women: a case-control study. Int J Surg 2016; 34: 81-5.
- Kennedy A. Assessment of acute abdominal pain in the pregnant patient. Semin Ultrasound CT MR 2000; 21: 64-77.
- Old JL, Dusing RW, Yap W, et al. Imaging for suspected appendicitis. Am Fam Physician 2005; 71: 71-8.
- Kereshi B, Lee KS, Siewert B, et al. Clinical utility of magnetic resonance imaging in the evaluation of pregnant females with suspected acute appendicitis. Abdom Radiol (NY) 2018; 43: 1446-55.
- Pedrosa I, Lafornara M, Pandharipande PV, et al. Pregnant patients suspected of having acute appendicitis: effect of MR imaging on negative laparotomy rate and appendiceal perforation rate. Radiology 2009; 250: 749-57.
- Rha SE, Byun JY, Jung SE, et al. CT and MR imaging features of adnexal torsion. Radiographics 2002; 22: 283-94.
- Fidler JL, Guimaraes L, Einstein DM. MR imaging of the small bowel. Radiographics 2009; 29: 1811-25.
- Jung SJ, Lee DK, Kim JH, et al. Appendicitis during Pregnancy: The Clinical Experience of a Secondary Hospital. J Korean Soc Coloproctol 2012; 28: 152-9.
- Oto A, Ernst RD, Shah R, et al. Right-lower-quadrant pain and suspected appendicitis in pregnant women: evaluation with MR imaging--initial experience. Radiology 2005; 234: 445-51.
- Lim HK, Bae SH, Seo GS. Diagnosis of acute appendicitis in pregnant women: value of sonography. AJR Am J Roentgenol. 1992; 159: 539-42.
- Zhang Y, Zhao YY, Qiao J, et al. Diagnosis of appendicitis during pregnancy and perinatal outcome in the late pregnancy. Chin Med J (Engl) 2009; 122: 521-4.
- Pedrosa I, Levine D, Eyvazzadeh AD, et al. MR imaging evaluation of acute appendicitis in pregnancy. Radiology 2006; 238: 891-9.
- Mourad J, Elliott JP, Erickson L, et al. Appendicitis in pregnancy: new information that contradicts long-held clinical beliefs. Am J Obstet Gynecol 2000; 182: 1027-9.
- Hee P, Viktrup L. The diagnosis of appendicitis during pregnancy and maternal and fetal outcome after appendectomy. Int J Gynaecol Obstet 1999; 65: 129-35.
- Dinc K, Ekinci T, Cıplak B, et al. A rare acute abdomen case in pregnancy: myoma torsion. J Health Sci Med 2018; 2: 47-9.
- Theilen LH, Mellnick VM, et al. Utility of magnetic resonance imaging for suspected appendicitis in pregnant women. Am J Obstet Gynecol 2015; 212: 345
- Burns M, Hague CJ, Vos P, Tiwari P, Wiseman SM. Utility of Magnetic Resonance Imaging for the Diagnosis of Appendicitis During Pregnancy: A Canadian Experience. Can Assoc Radiol J 2017; 68:392-400.
- Wi SA, Kim DJ, Cho ES, Kim KA. Diagnostic performance of MRI for pregnant patients with clinically suspected appendicitis. Abdom Radiol (NY) 2018; 43: 3456-61.
- Kotecha HM, McIntosh LJ, Lo HS, et al. What to Expect When They are Expecting: Magnetic Resonance Imaging of the Acute Abdomen and Pelvis in Pregnancy. Curr Probl Diagn Radiol 2017; 46: 423-31.
- Baheti AD, Nicola R, Bennett GL, et al. Magnetic Resonance Imaging of Abdominal and Pelvic Pain in the Pregnant Patient. Magn Reson Imaging Clin N Am 2016; 24: 403-17.
Efficacy of magnetic resonance imaging among pregnant patients diagnosed with acute abdomen in the emergency department
Abstract
Aims: Diagnostic procedures are very important for fetal safety during pregnancy. Magnetic resonance imaging (MRI) is characterized by a higher accuracy rate compared to medical follow-up and post-surgical diagnoses. However, it is very important to use it at the right time in order to maintain cost-effectiveness of the technique. In this study, we aimed to determine the efficacy of MRI in pregnant patients admitted to the emergency department with acute abdominal pain when the etiology has not been defined by other techniques.
Methods: The data of pregnant patients who admitted to the emergency department due to acute abdominal pain between January 2013 and February 2018 were retrospectively analyzed. All these patients evaluated with pelvic magnetic resonance screening, as they could not be diagnosed by physical examination findings, laboratory tests, or ultrasonography. Diagnostic performance of MRI, sensitivity, specificity, and negative and positive predictive values were assessed.
Results: The etiology of the pain was detected in 29 of 57 patients who applied to the emergency department with acute abdominal pain and evaluated with pelvic MRI. The most common cause of acute abdominal pain was acute appendicitis which all of them histopathologically confirmed (n=14). Pelvic abscess, severe hydronephrosis, giant ovarian cyst, pyelonephritis, ovarian torsion, and uterine fibroid torsion were among other causes.
Conclusion: MRI is a highly effective imaging method for diagnosing both acute appendicitis and other pelvic emergencies. Therefore, it would be beneficial for the diagnosis in pregnant patients with acute abdominal pain.
References
- Segev L, Segev Y, Rayman S, et al. The diagnostic performance of ultrasound for acute appendicitis in pregnant and young nonpregnant women: a case-control study. Int J Surg 2016; 34: 81-5.
- Kennedy A. Assessment of acute abdominal pain in the pregnant patient. Semin Ultrasound CT MR 2000; 21: 64-77.
- Old JL, Dusing RW, Yap W, et al. Imaging for suspected appendicitis. Am Fam Physician 2005; 71: 71-8.
- Kereshi B, Lee KS, Siewert B, et al. Clinical utility of magnetic resonance imaging in the evaluation of pregnant females with suspected acute appendicitis. Abdom Radiol (NY) 2018; 43: 1446-55.
- Pedrosa I, Lafornara M, Pandharipande PV, et al. Pregnant patients suspected of having acute appendicitis: effect of MR imaging on negative laparotomy rate and appendiceal perforation rate. Radiology 2009; 250: 749-57.
- Rha SE, Byun JY, Jung SE, et al. CT and MR imaging features of adnexal torsion. Radiographics 2002; 22: 283-94.
- Fidler JL, Guimaraes L, Einstein DM. MR imaging of the small bowel. Radiographics 2009; 29: 1811-25.
- Jung SJ, Lee DK, Kim JH, et al. Appendicitis during Pregnancy: The Clinical Experience of a Secondary Hospital. J Korean Soc Coloproctol 2012; 28: 152-9.
- Oto A, Ernst RD, Shah R, et al. Right-lower-quadrant pain and suspected appendicitis in pregnant women: evaluation with MR imaging--initial experience. Radiology 2005; 234: 445-51.
- Lim HK, Bae SH, Seo GS. Diagnosis of acute appendicitis in pregnant women: value of sonography. AJR Am J Roentgenol. 1992; 159: 539-42.
- Zhang Y, Zhao YY, Qiao J, et al. Diagnosis of appendicitis during pregnancy and perinatal outcome in the late pregnancy. Chin Med J (Engl) 2009; 122: 521-4.
- Pedrosa I, Levine D, Eyvazzadeh AD, et al. MR imaging evaluation of acute appendicitis in pregnancy. Radiology 2006; 238: 891-9.
- Mourad J, Elliott JP, Erickson L, et al. Appendicitis in pregnancy: new information that contradicts long-held clinical beliefs. Am J Obstet Gynecol 2000; 182: 1027-9.
- Hee P, Viktrup L. The diagnosis of appendicitis during pregnancy and maternal and fetal outcome after appendectomy. Int J Gynaecol Obstet 1999; 65: 129-35.
- Dinc K, Ekinci T, Cıplak B, et al. A rare acute abdomen case in pregnancy: myoma torsion. J Health Sci Med 2018; 2: 47-9.
- Theilen LH, Mellnick VM, et al. Utility of magnetic resonance imaging for suspected appendicitis in pregnant women. Am J Obstet Gynecol 2015; 212: 345
- Burns M, Hague CJ, Vos P, Tiwari P, Wiseman SM. Utility of Magnetic Resonance Imaging for the Diagnosis of Appendicitis During Pregnancy: A Canadian Experience. Can Assoc Radiol J 2017; 68:392-400.
- Wi SA, Kim DJ, Cho ES, Kim KA. Diagnostic performance of MRI for pregnant patients with clinically suspected appendicitis. Abdom Radiol (NY) 2018; 43: 3456-61.
- Kotecha HM, McIntosh LJ, Lo HS, et al. What to Expect When They are Expecting: Magnetic Resonance Imaging of the Acute Abdomen and Pelvis in Pregnancy. Curr Probl Diagn Radiol 2017; 46: 423-31.
- Baheti AD, Nicola R, Bennett GL, et al. Magnetic Resonance Imaging of Abdominal and Pelvic Pain in the Pregnant Patient. Magn Reson Imaging Clin N Am 2016; 24: 403-17.
Details
| Primary Language | English |
|---|---|
| Subjects | Radiology and Organ Imaging, Health Care Administration |
| Journal Section | Research Articles |
| Authors | |
| Early Pub Date | July 26, 2023 |
| Publication Date | July 28, 2023 |
| Published in Issue | Year 2023 Volume: 5 Issue: 3 |
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