Magnetic resonance imaging reduces the rate of unnecessary operations in pregnant patients with suspected acute appendicitis: a retrospective study

Beatrice Lukenaite; Raminta Luksaite-Lukste; Saulius Mikalauskas; Arturas Samuilis; Kestutis Strupas; Tomas Poškus

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자료유형: 학술저널

저자정보: Beatrice Lukenaite (Vilnius University) Raminta Luksaite-Lukste (Vilnius University) Saulius Mikalauskas (Vilnius University) Arturas Samuilis (Vilnius University) Kestutis Strupas (Vilnius University) Tomas Poškus (Vilnius University)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.100 No.1

발행연도: 2021.1

수록면: 40 - 46 (7page)

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Purpose: This is a retrospective single-institution study performed to compare the rate of unnecessary operations in pregnant women with suspected acute appendicitis with and without the use of MRI.
Methods: The study subjects were all pregnant women with suspected acute appendicitis admitted to a tertiary institution from January 2012 to December 2019. If acute appendicitis was not excluded clinically and by ultrasound (US), laparoscopies were performed until May 2017 (US-only group). MRI was added as a diagnostic tool when US was inconclusive from May 2017 (US + MRI group). Surgery was considered unnecessary when no inflamed appendix was found. The rate of unnecessary surgery, postoperative complications, length of stay were analyzed.
Results: Seventy-six women were included in the study; 38 women in the US-only group and 38 women in the US + MRI group. There were no differences in admission characteristics between the groups. One of 38 women (2.6%) underwent unnecessary surgery in the US + MRI group vs. 10 of 38 (26.3%) in the US-only group (P = 0.007). The patients in the US + MRI group were significantly less likely to undergo a diagnostic operation than in the US-only group (5.26% vs. 55.3%, respectively; P < 0.001) and their hospital stay was significantly shorter (0.74 ± 1.64 days vs. 3.7 ± 3.0 days, respectively; P < 0.001). The obstetric outcomes were not different between the groups. MRI had a sensitivity of 83.3% and specificity of 100% in the series.
Conclusion: The rate of unnecessary surgery was significantly reduced in pregnant women, who underwent MRI after inconclusive transabdominal US.

#Appendicitis #Diagnostic imaging #Magnetic resonance imaging #Pregnancy

참고문헌 (30)

참고문헌 신청

Kryzauskas M / 2016 / Is acute appendicitis still misdiagnosed? / Open Med (Wars) 11:231~236

Bhangu A / 2020 / RIFT Study Group on behalf of the West Midlands Research Collaborative. Evaluation of appendicitis risk prediction models in adults with suspected appendicitis / Br J Surg 107:73~86

Kave M / 2019 / Pregnancy and appendicitis: a systematic review and meta-analysis on the clinical use of MRI in diagnosis of appendicitis in pregnant women / World J Emerg Surg 14:37

De Wilde JP / 2005 / A review of the current use of magnetic resonance imaging in pregnancy and safety implications for the fetus / Prog Biophys Mol Biol 87:335~353

Mourad J / 2000 / Appendicitis in pregnancy: new information that contradicts long-held clinical beliefs / Am J Obstet Gynecol 182:1027~1029

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