지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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Objective: The sensitivity of ultrasonography is poor in pregnant women with suspected appendicitis. Additional magnetic resonance imaging (MRI) is usually required, which can delay the diagnosis and surgical intervention. We hypothesized that the use of MRI as the first diagnostic tool could increase the detection rate and reduce the time for diagnosis.
Therefore, we sought to investigate the diagnostic yield of ultrasonography vs. MRI and the emergency department length of stay (ED-LOS) of pregnant women with suspected appendicitis.
Methods: This was a retrospective, observational study in the ED of a single tertiary teaching hospital from January 2010 to December 2017. Patients who underwent ultrasonography or MRI or both were enrolled. The primary outcome was the diagnostic yield of acute appendicitis and the ED-LOS. The secondary outcome was the proportion of complicated appendicitis cases.
Results: A total of 145 pregnant women were enrolled (ultrasonography only, n=73; MRI only, n=26; both ultrasonography and MRI, n=46). The diagnostic yield was 23.5% (28/119) by ultrasonography and 79.2% (57/72) by MRI. The diagnostic yield of ultrasonography was significantly lower than that of MRI, especially in the second and third trimesters. The ED-LOS was significantly longer in the ultrasonography plus MRI group than that in the MRI-only group (9 hours vs. 6 hours, P=0.002).
Conclusion: In this study, MRI had a higher diagnostic yield than ultrasonography and can reduce the time to diagnosis.
Thus, MRI should be considered as the first diagnostic tool for suspected acute appendicitis in pregnant women.
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참고문헌 (29)
참고문헌 신청
Tamir IL / 1990 / Acute appendicitis in the pregnant patient / Am J Surg 160:571~575
Andersen B / 1999 / Appendicitis in pregnancy : diagnosis, management and complications / Acta Obstet Gynecol Scand 78:758~762
Franca Neto AH / 2015 / Acute appendicitis in pregnancy : literature review / Rev Assoc Med Bras(1992) 61:170~177
Smith MP / 2015 / ACR Appropriateness Criteria(R)right lower quadrant pain : suspected appendicitis / Ultrasound Q 31:85~91
Oto A / 2006 / Revisiting MRI for appendix location during pregnancy / AJR Am J Roentgenol 186:883~887
Andersen B / 1999 / Appendicitis in pregnancy : diagnosis, management and complications / Acta Obstet Gynecol Scand 78:758~762
Franca Neto AH / 2015 / Acute appendicitis in pregnancy : literature review / Rev Assoc Med Bras(1992) 61:170~177
Smith MP / 2015 / ACR Appropriateness Criteria(R)right lower quadrant pain : suspected appendicitis / Ultrasound Q 31:85~91
Oto A / 2006 / Revisiting MRI for appendix location during pregnancy / AJR Am J Roentgenol 186:883~887
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