Can diffusion-weighted imaging be a gold standard method for acute appendicitis? A comparative study


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Serinsoz S., Akturk R.

Iranian Journal of Radiology, vol.18, no.3, 2021 (SCI-Expanded, Scopus) identifier

  • Publication Type: Article / Article
  • Volume: 18 Issue: 3
  • Publication Date: 2021
  • Doi Number: 10.5812/iranjradiol.113603
  • Journal Name: Iranian Journal of Radiology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL, EMBASE, Veterinary Science Database
  • Keywords: Acute appendicitis, Diffusion-weighted imaging, Non-enhanced computed tomography, Ultrasonography
  • Open Archive Collection: AVESIS Open Access Collection
  • Istanbul Gelisim University Affiliated: Yes

Abstract

© 2021, Author(s).Background: Diagnosis of an inflamed appendix is commonly based on clinical, laboratory, and diagnostic imaging data. Ultra-sonography (US) is the leading diagnostic modality for these patients. However, an inconclusive US examination suggests the application of non-enhanced computed tomography (NECT). Objectives: This study aimed to compare US, NECT, and diffusion-weighted magnetic resonance imaging (DW-MRI) examinations for an accurate diagnosis of acute appendicitis with the rate of proven appendicitis by surgery. Patients and Methods: This retrospective study was performed on 70 patients, diagnosed with acute appendicitis between February 2018 and January 2020. The diagnostic accuracy of US, CT, and DW-MRI for acute appendicitis was examined in relation to the demographic and clinical variables. Results: Age and gender were not significantly associated with surgically proven appendicitis. However, the appendix diameter had a significant association with surgically proven appendicitis. All DW-MRI–positive patients with acute abdominal symptoms were surgically diagnosed with acute/subacute appendicitis (even those with < 6 mm in diameter). Based on the ROC curve analysis, the sensitivity and specificity of DW-MRI in predicting acute appendicitis was 100% and 90.90%, respectively. Conclusion: The appendix diameter was an important factor in diagnosing acute appendicitis. However, DW-MRI is an advanced technique that may exclude the need for the appendix diameter measurements.