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An implemented MRI program to eliminate radiation from the evaluation of pediatric appendicitis.
- Source :
-
Journal of pediatric surgery [J Pediatr Surg] 2015 Aug; Vol. 50 (8), pp. 1359-63. Date of Electronic Publication: 2014 Dec 19. - Publication Year :
- 2015
-
Abstract
- Background: Recent efforts have been directed at reducing ionizing radiation delivered by CT scans to children in the evaluation of appendicitis. MRI has emerged as an alternative diagnostic modality. The clinical outcomes associated with MRI in this setting are not well-described.<br />Methods: Review of a 30-month institutional experience with MRI as the primary diagnostic evaluation for suspected appendicitis (n=510). No intravenous contrast, oral contrast, or sedation was administered. Radiologic and clinical outcomes were abstracted.<br />Results: MRI diagnostic characteristics were: sensitivity 96.8% (95% CI: 92.1%-99.1%), specificity 97.4% (95% CI: 95.3-98.7), positive predictive value 92.4% (95% CI: 86.5-96.3), and negative predictive value 98.9% (95% CI: 97.3%-99.7%). Radiologic time parameters included: median time from request to scan, 71 minutes (IQR: 51-102), imaging duration, 11 minutes (IQR: 8-17), and request to interpretation, 2.0 hours (IQR: 1.6-2.6). Clinical time parameters included: median time from initial assessment to admit order, 4.1 hours (IQR: 3.1-5.1), assessment to antibiotic administration 4.7 hours (IQR: 3.9-6.7), and assessment to operating room 9.1 hours (IQR: 5.8-12.7). Median length of stay was 1.2 days (range: 0.2-19.5).<br />Conclusion: Given the diagnostic accuracy and favorable clinical outcomes, without the potential risks of ionizing radiation, MRI may supplant the role of CT scans in pediatric appendicitis imaging.<br /> (Copyright © 2015 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Child
Child, Preschool
Female
Hospitalization statistics & numerical data
Humans
Infant
Male
Outcome Assessment, Health Care
Program Evaluation
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed
Appendicitis diagnosis
Magnetic Resonance Imaging
Radiation Exposure prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1531-5037
- Volume :
- 50
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Journal of pediatric surgery
- Publication Type :
- Academic Journal
- Accession number :
- 25783291
- Full Text :
- https://doi.org/10.1016/j.jpedsurg.2014.12.012