Magnetic Resonance Imaging Provides Useful Diagnostic Information Following Equivocal Ultrasound in Children With Suspected Appendicitis

• DOI: 10.1177/0846537121993797
• Publication Date: 2021-03-02T05:23:12Z
• Authors: Jelena Komanchuk; Dori-Ann Martin; Rory Killam; Robin Eccles; Mary E. Brindle; Ijab Khanafer; Ari R. Joffe; Jaime Blackwood; Weiming Yu; Priya Gupta; Sanjay Sethi; Vijay Moorjani; Graham Thompson
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

In Canada, ultrasonography is the primary imaging modality for children with suspected appendicitis, yet equivocal studies are common. Magnetic resonance provides promise as an adjunct strategy. The objective of this study was to determine proportion appendicitis and ultrasound where magnetic determined a diagnosis.A prospective consecutive cohort aged 5-17 years presenting tertiary pediatric Emergency Department were enrolled. Participants underwent diagnostic management strategies according our local pathway, followed by (Siemens Avanto 1.5 Tesla) imaging. Sub-specialty radiologists reported all images.Magnetic performed in 101 appendicitis. mean age 11.9 (SD 3.4) median Pediatric Appendicitis Score 6 [IQR 4,8]. Ultrasonography completed 98/101 (97.0%). Of 53/98 (54.1%) ultrasound, provided further information 41 (77.4%; 10 positive, 31 negative; 12 remained equivocal). Secondary findings on included abdominal free fluid (24, 45.3%), peri-appendiceal (12, 22.6%), intraluminal appendiceal (9, 17.0%), fat stranding (8, 15.1%), appendicolith (2, 3.8%), abscess (1, 1.9%). observed agreement between results final diagnosis 94.9% (kappa = 0.89).