ACUTE APPENDICITIS - MR-IMAGING AND SONOGRAPHIC CORRELATION

OBJECTIVE. Acute appendicitis is the most common indication for emerge ncy abdominal surgery. To our knowledge, MR imaging has not been compa red with sonography for revealing acute appendicitis. Our aim was to a ssess and compare the accuracy, advantages, and limitations of MR imag ing and sonography in revealing appendicitis. SUBJECTS AND METHODS. Th e study included 60 consecutive patients suspected of having appendici tis who underwent abdominal sonography and MR imaging. Fat-suppressed T2-weighted fast spin-echo and gadolinium-enhanced fat-suppressed T1-w eighted spin-echo axial and coronal images were obtained. The initial MR imaging and sonographic studies were later correlated with the surg ical-pathologic findings, follow-up evaluations, and diagnosis at the time of discharge. RESULTS. Surgical, histopathologic, and follow-up r esults revealed that 34 patients had appendicitis. Of the 26 patients without appendicitis, 15 with symptoms of acute appendicitis had no pa thologic diagnoses and the remaining 11 had another diagnosis. Compari son of the sensitivity, accuracy, and negative predictive values for M R imaging and sonography was found to be statistically significant (p <.05, chi-square test), indicating that MR imaging was superior to son ography in revealing appendicitis. We found no statistical difference in specificity and positive predictive value for MR imaging and sonogr aphy. CONCLUSION. Despite some disadvantages, we found MR imaging to b e superior to sonography in revealing suspected acute appendicitis. MR imaging can be used after suboptimal or nondiagnostic sonography in c ases of suspected acute appendicitis.