Document Detail


Right-lower-quadrant pain and suspected appendicitis in pregnant women: evaluation with MR imaging--initial experience.
MedLine Citation:
PMID:  15591434     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To determine if there is a role for magnetic resonance (MR) imaging in evaluation of pregnant women with acute right-lower-quadrant pain in whom acute appendicitis is suspected. MATERIALS AND METHODS: Informed consent and institutional review board approval were obtained. Images obtained with a 1.5-T MR imager and medical records of 23 pregnant women (age range, 19-34 years; mean age, 24.7 years) who presented with acute right-lower-quadrant pain were retrospectively reviewed. MR protocol included use of transverse, coronal, and sagittal noncontiguous T2-weighted single-shot fast spin-echo (SE) sequences; transverse fat-suppressed T2-weighted fast SE sequences; transverse T1-weighted gradient-recalled-echo sequences; and transverse and coronal short inversion time inversion-recovery sequences performed through the lower abdomen and pelvis. MR findings were evaluated by two radiologists and compared with surgical and pathologic findings and clinical follow-up data. RESULTS: Appendix was detected in 20 (86.9%) of 23 patients. Seven patients underwent surgery; four had acute appendicitis, and three had ovarian torsion. Two patients with pelvic abscesses not related to appendicitis underwent percutaneous drainage. Fourteen patients were treated medically. Dilated thick-walled appendix and periappendiceal inflammation were detected in three (75%) of four patients with acute appendicitis. In one patient with appendicitis, the appendix could not be visualized, but inflammation was present in the right lower quadrant. In three patients with ovarian torsion, MR imaging demonstrated right adnexal mass or inflammation. MR imaging was used to correctly identify pelvic abscesses and healthy appendix in two patients. A healthy appendix was depicted in 17 (89.5%) of 19 patients without acute appendicitis. CONCLUSION: MR imaging shows promise for evaluation of pregnant women in whom acute appendicitis is suspected by enabling diagnosis of other possible causes of right-lower-quadrant pain, including ovarian torsion or pelvic abscesses, and demonstrating a healthy or unhealthy appendix.
Authors:
Aytekin Oto; Randy D Ernst; Rajeev Shah; Mert Koroglu; Gregory Chaljub; Alfredo F Gei; Nikolaos Zacharias; George Saade
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Publication Detail:
Type:  Journal Article     Date:  2004-12-10
Journal Detail:
Title:  Radiology     Volume:  234     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-26     Completed Date:  2005-03-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  445-51     Citation Subset:  AIM; IM    
Copyright Information:
(c) RSNA, 2004.
Affiliation:
Department of Radiology, University of Texas Medical Branch at Galveston, 301 University Blvd, Galveston, TX 77555-0709, USA. ayoto@utmb.edu
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MeSH Terms
Descriptor/Qualifier:
Abdominal Abscess / diagnosis
Abdominal Pain / diagnosis*
Acute Disease
Adult
Appendicitis / diagnosis*,  surgery
Female
Humans
Magnetic Resonance Imaging* / methods
Ovarian Diseases / diagnosis
Pelvic Inflammatory Disease / diagnosis
Pregnancy
Pregnancy Complications / diagnosis*
Retrospective Studies
Torsion Abnormality

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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