Right-lower-quadrant pain and suspected appendicitis in pregnant women: Evaluation with MR imaging - Initial experience

Aytekin Oto, Randy D. Ernst, Rajeev Shah, Mert Koroglu, Gregory Chaljub, Alfredo F. Gei, Nikolaos Zacharias, George Saade

Research output: Contribution to journalArticle

113 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)445-451
Number of pages7
JournalRadiology
Volume234
Issue number2
DOIs
StatePublished - Feb 2005

Fingerprint

Appendicitis
Pregnant Women
Magnetic Resonance Imaging
Pain
Abscess
Magnetic Resonance Spectroscopy
Inflammation
Sequence Inversion
Research Ethics Committees
Informed Consent
Pelvis
Abdomen
Medical Records
Drainage
Fats

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Right-lower-quadrant pain and suspected appendicitis in pregnant women : Evaluation with MR imaging - Initial experience. / Oto, Aytekin; Ernst, Randy D.; Shah, Rajeev; Koroglu, Mert; Chaljub, Gregory; Gei, Alfredo F.; Zacharias, Nikolaos; Saade, George.

In: Radiology, Vol. 234, No. 2, 02.2005, p. 445-451.

Research output: Contribution to journalArticle

Oto, Aytekin ; Ernst, Randy D. ; Shah, Rajeev ; Koroglu, Mert ; Chaljub, Gregory ; Gei, Alfredo F. ; Zacharias, Nikolaos ; Saade, George. / Right-lower-quadrant pain and suspected appendicitis in pregnant women : Evaluation with MR imaging - Initial experience. In: Radiology. 2005 ; Vol. 234, No. 2. pp. 445-451.
@article{27511d4ad03746b8aa964007a934bcb4,
title = "Right-lower-quadrant pain and suspected appendicitis in pregnant women: Evaluation with MR imaging - Initial experience",
abstract = "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.",
author = "Aytekin Oto and Ernst, {Randy D.} and Rajeev Shah and Mert Koroglu and Gregory Chaljub and Gei, {Alfredo F.} and Nikolaos Zacharias and George Saade",
year = "2005",
month = "2",
doi = "10.1148/radiol.2341032002",
language = "English (US)",
volume = "234",
pages = "445--451",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "2",

}

TY - JOUR

T1 - Right-lower-quadrant pain and suspected appendicitis in pregnant women

T2 - Evaluation with MR imaging - Initial experience

AU - Oto, Aytekin

AU - Ernst, Randy D.

AU - Shah, Rajeev

AU - Koroglu, Mert

AU - Chaljub, Gregory

AU - Gei, Alfredo F.

AU - Zacharias, Nikolaos

AU - Saade, George

PY - 2005/2

Y1 - 2005/2

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=12344329395&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=12344329395&partnerID=8YFLogxK

U2 - 10.1148/radiol.2341032002

DO - 10.1148/radiol.2341032002

M3 - Article

C2 - 15591434

AN - SCOPUS:12344329395

VL - 234

SP - 445

EP - 451

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 2

ER -