An implemented MRI program to eliminate radiation from the evaluation of pediatric appendicitis

Journal of Pediatric Surgery
Afif N KulaylatRobert E Cilley

Abstract

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. 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. 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). Given the ...Continue Reading

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Citations

Apr 19, 2016·Journal of Medical Radiation Sciences·Tristan ReddanFiona Harden
Oct 6, 2015·The Journal of Surgical Research·Ramon R GorterJohanna H van der Lee
May 3, 2016·Emergency Medicine Clinics of North America·David J CarlbergJeffrey S Dubin
May 28, 2016·Pediatric Radiology·Michael M MooreSosamma T Methratta
Aug 16, 2016·Seminars in Pediatric Surgery·Charity C Glass, Shawn J Rangel
Oct 16, 2016·Pediatric Surgery International·Rebecca M RenteaCharles L Snyder
Jan 22, 2017·Pediatric Radiology·Gray R LyonsArzu Kovanlikaya
Aug 15, 2018·AJR. American Journal of Roentgenology·David W SwensonEdward Y Lee
Jul 26, 2018·Pediatric Emergency Care·Ryan KearneyEileen Klein
Jan 5, 2019·Pediatric Emergency Care·Manoj K Mittal
Apr 17, 2020·Journal of Autism and Developmental Disorders·Patrick T ReevesCade Nylund
Mar 19, 2019·Journal of Magnetic Resonance Imaging : JMRI·Benjamin M MervakLauren M Burke
Feb 8, 2021·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·Ricardo RassiEduardo Cuestas
Mar 6, 2021·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Kathryn E Kasmire, Joshua Davis
May 27, 2020·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·Johanna GudjonsdottirMartin Salö

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