Utility of diffusion-weighted imaging in the diagnosis of acute appendicitis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Ercan Inci & Ozgur Kilickesmez & Elif Hocaoglu & Sibel Aydin & Sibel Bayramoglu & Tan Cimilli
- چاپ و سال / کشور: 2010
Description
Objectives To evaluate the value of diffusion-weighted MRI (DWI) in the diagnosis of acute appendicitis. Methods 119 patients with acute appendicitis and 50 controls were enrolled in this prospective study. DWI was obtained with b factors 0, 500 and 1000 s/mm² and were assessed with a visual scoring system by two radiologists followed by quantitative evaluation of the DW images and ADC maps. Results Histopathology revealed appendicitis in 79/92 patients (78%) who had undergone surgery. On visual evaluation, except for one patient with histopathologically proven appendicitis all inflamed appendixes were hyperintense on DWI (98.7%). Quantitative evaluation with DW signal intensities and ADC values revealed a significant difference with normal and inflamed appendixes (p<0.001). The best discriminative parameter was signal intensity (b 500). With a cut-off value of 56 for the signal intensity the ratio had a sensitivity of 99% and a specificity of 97%. The cut-off ADC value at 1.66 mm²/s had a sensitivity of 97% and a specificity of 99%. Conclusion DWI is a valuable technique for the diagnosis of acute appendicitis with both qualitative and quantitative evaluation. DWI increases the conspicuity of the inflamed appendix. We recommend using DWI to diagnose acute appendicitis.
Eur Radiol (2011) 21:768–775 DOI 10.1007/s00330-010-1981-6 Received: 16 April 2010 / Accepted: 16 August 2010 / Published online: 6 October 2010
