Yes / Appendicitis is the most common cause of acute abdominal pain requiring surgical intervention
in paediatric patients. Ultrasound is generally the diagnostic imaging modality of choice, followed
by CT, where paediatric appendicitis is suspected. However, high operator dependency and
diagnostic restrictions related to anatomical and clinical presentation may limit consistency of application.
This paper explores whether MRI is a viable alternative to ultrasound as the primary imaging
modality.
Method: A systematic review of the literature was undertaken. A search of Medline, Cinahl, PubMed
Central and Google Scholar was undertaken supplemented by a review of reference lists, author
searching and review of NICE evidence base for existing guidelines. Included studies were assessed for
bias using the QUADAS-2 quality assessment tool and data were extracted systematically using a purposefully
designed electronic data extraction proforma.
Results: Seven studies were included in final review. The age range of participants extended from 0 to 19
years. Only one study with a patient age range of 0e14 used sedation. Sensitivity estimates from the
included studies ranged from 92% to 100% while specificity ranged from 89% to 100%. A significant
variation in the number and type of sequences was noted between the studies.
Conclusion: MRI offers high sensitivity and specificity comparable to contrast enhanced CT and greater
than ultrasound as reported in the literature. Where accessibility is not a restriction, MRI is a viable
alternative to ultrasound in the assessment and diagnosis of paediatric appendicitis. Clinical practice
recommendations have been provided to facilitate the translation of evidence into practice.
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/7934 |
| Date | 02 January 2016 |
| Creators | Ogunmefun, G., Hardy, Maryann L., Boynes, Stephen |
| Source Sets | Bradford Scholars |
| Language | English |
| Detected Language | English |
| Type | Article, Accepted manuscript |
| Rights | © 2016 Elsevier. Reproduced in accordance with the publisher's self-archiving policy. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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