The Effect of Unenhanced MRI on the Surgeons’ Decision-Making Process in Females with Suspected Appendicitis
Background This prospective study evaluated the impact of the results of unenhanced magnetic resonance imaging (MRI) on the surgeon’s diagnosis of acute appendicitis in potentially fertile females. Methods 112 female patients, aged 12–55, with suspected appendicitis underwent MRI of the abdomen. At...
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| Veröffentlicht in: | World journal of surgery 2016-12, Vol.40 (12), p.2881-2887 |
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| creator | Ziedses des Plantes, C. M. P. van Veen, M. J. F. van der Palen, J. Klaase, J. M. Gielkens, H. A. J. Geelkerken, R. H. |
| description | Background
This prospective study evaluated the impact of the results of unenhanced magnetic resonance imaging (MRI) on the surgeon’s diagnosis of acute appendicitis in potentially fertile females.
Methods
112 female patients, aged 12–55, with suspected appendicitis underwent MRI of the abdomen. At three defined intervals; admission and clinical re-evaluation before and after revealing the MRI results, the surgeon recorded the attendance of each patient in operative treatment, observation or discharge. Appendicitis was confirmed or declined by pathology or by telephone follow-up in case of non-intervention.
Findings
Appendicitis was confirmed in 29 of 112 patients. At admission the surgeon’s disposition had a sensitivity of 97 % and specificity of 29 %. After knowing the MRI results, sensitivity was 97 % and specificity 64 %. The sensitivity and specificity of MRI alone were 89 and 100 %, with a negative and positive predictive value of 96 and 100 %, respectively.
Conclusion
We believe that MRI should perhaps be standard in all female patients during their reproductive years with suspected appendicitis. It avoids an operation in 32 % of cases and allows earlier planning for patients with an equivocal clinical picture. Trial number: OND1292733 (Narcis.nl). |
| doi_str_mv | 10.1007/s00268-016-3626-7 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5104813</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1846416017</sourcerecordid><originalsourceid>FETCH-LOGICAL-c6231-98fe92ef6d19f6d1383f75db73b068274a6f74974a838ca8ef00f4728c0519c43</originalsourceid><addsrcrecordid>eNqNkc1u1DAUhSMEokPhAdggS2zYhPoncewNUikdKGoFoq1YWh7nesYlYwc7oeqO1-D1eJI6SqkKEoKNryV_5-j4nqJ4SvBLgnGzlzCmXJSY8JJxysvmXrEgFaMlZZTdLxaY8SrfCdspHqV0gTFpOOYPix3aVLJmpF4U_mwD6NBaMAMKFp178BvtDbTo5NMRCh4N-f10jGsIPv38_gO9AeOSC7480V-cX6OPMRhICTmPlrDVHSR06YZN1qQ-m2aj_b4H3zrjBpceFw-s7hI8uZm7xfny8OzgXXn84e3Rwf5xaXjOW0phQVKwvCVyOphgtqnbVcNWmIucXnObv5CnYMJoARZjWzVUGFwTaSq2W7yafftxtYXWgB-i7lQf3VbHKxW0U7-_eLdR6_BN1QRXgrBs8OLGIIavI6RBbV0y0HXaQxiTIqLiFeF5o_-BMklw7kdm9Pkf6EUYo8-bmKhGSCmaiSIzZWJIKYK9zU2wmopXc_EqF6-m4tUU4tndD98qfjWdATkDl66Dq387qs_vT18vscCUZC2dtSnL_Brindh_TXQNrKPJyg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1837899879</pqid></control><display><type>article</type><title>The Effect of Unenhanced MRI on the Surgeons’ Decision-Making Process in Females with Suspected Appendicitis</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals</source><creator>Ziedses des Plantes, C. M. P. ; van Veen, M. J. F. ; van der Palen, J. ; Klaase, J. M. ; Gielkens, H. A. J. ; Geelkerken, R. H.</creator><creatorcontrib>Ziedses des Plantes, C. M. P. ; van Veen, M. J. F. ; van der Palen, J. ; Klaase, J. M. ; Gielkens, H. A. J. ; Geelkerken, R. H.</creatorcontrib><description>Background
This prospective study evaluated the impact of the results of unenhanced magnetic resonance imaging (MRI) on the surgeon’s diagnosis of acute appendicitis in potentially fertile females.
Methods
112 female patients, aged 12–55, with suspected appendicitis underwent MRI of the abdomen. At three defined intervals; admission and clinical re-evaluation before and after revealing the MRI results, the surgeon recorded the attendance of each patient in operative treatment, observation or discharge. Appendicitis was confirmed or declined by pathology or by telephone follow-up in case of non-intervention.
Findings
Appendicitis was confirmed in 29 of 112 patients. At admission the surgeon’s disposition had a sensitivity of 97 % and specificity of 29 %. After knowing the MRI results, sensitivity was 97 % and specificity 64 %. The sensitivity and specificity of MRI alone were 89 and 100 %, with a negative and positive predictive value of 96 and 100 %, respectively.
Conclusion
We believe that MRI should perhaps be standard in all female patients during their reproductive years with suspected appendicitis. It avoids an operation in 32 % of cases and allows earlier planning for patients with an equivocal clinical picture. Trial number: OND1292733 (Narcis.nl).</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-016-3626-7</identifier><identifier>PMID: 27495315</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Acute Appendicitis ; Acute Disease ; Adolescent ; Adult ; Appendicitis ; Appendicitis - diagnostic imaging ; Appendicitis - surgery ; Cardiac Surgery ; Child ; Decision Making ; Diagnostic Laparoscopy ; Female ; General Surgery ; Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Imaging - methods ; Magnetic Resonance Imaging Finding ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Scientific Report ; Prospective Studies ; Surgeons ; Surgery ; Thoracic Surgery ; Vascular Surgery ; Young Adult</subject><ispartof>World journal of surgery, 2016-12, Vol.40 (12), p.2881-2887</ispartof><rights>The Author(s) 2016</rights><rights>2016 The Author(s)</rights><rights>Société Internationale de Chirurgie 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6231-98fe92ef6d19f6d1383f75db73b068274a6f74974a838ca8ef00f4728c0519c43</citedby><cites>FETCH-LOGICAL-c6231-98fe92ef6d19f6d1383f75db73b068274a6f74974a838ca8ef00f4728c0519c43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-016-3626-7$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-016-3626-7$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,41464,42533,45550,45551,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27495315$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ziedses des Plantes, C. M. P.</creatorcontrib><creatorcontrib>van Veen, M. J. F.</creatorcontrib><creatorcontrib>van der Palen, J.</creatorcontrib><creatorcontrib>Klaase, J. M.</creatorcontrib><creatorcontrib>Gielkens, H. A. J.</creatorcontrib><creatorcontrib>Geelkerken, R. H.</creatorcontrib><title>The Effect of Unenhanced MRI on the Surgeons’ Decision-Making Process in Females with Suspected Appendicitis</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
This prospective study evaluated the impact of the results of unenhanced magnetic resonance imaging (MRI) on the surgeon’s diagnosis of acute appendicitis in potentially fertile females.
Methods
112 female patients, aged 12–55, with suspected appendicitis underwent MRI of the abdomen. At three defined intervals; admission and clinical re-evaluation before and after revealing the MRI results, the surgeon recorded the attendance of each patient in operative treatment, observation or discharge. Appendicitis was confirmed or declined by pathology or by telephone follow-up in case of non-intervention.
Findings
Appendicitis was confirmed in 29 of 112 patients. At admission the surgeon’s disposition had a sensitivity of 97 % and specificity of 29 %. After knowing the MRI results, sensitivity was 97 % and specificity 64 %. The sensitivity and specificity of MRI alone were 89 and 100 %, with a negative and positive predictive value of 96 and 100 %, respectively.
Conclusion
We believe that MRI should perhaps be standard in all female patients during their reproductive years with suspected appendicitis. It avoids an operation in 32 % of cases and allows earlier planning for patients with an equivocal clinical picture. Trial number: OND1292733 (Narcis.nl).</description><subject>Abdominal Surgery</subject><subject>Acute Appendicitis</subject><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Appendicitis</subject><subject>Appendicitis - diagnostic imaging</subject><subject>Appendicitis - surgery</subject><subject>Cardiac Surgery</subject><subject>Child</subject><subject>Decision Making</subject><subject>Diagnostic Laparoscopy</subject><subject>Female</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Magnetic Resonance Imaging Finding</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Scientific Report</subject><subject>Prospective Studies</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Thoracic Surgery</subject><subject>Vascular Surgery</subject><subject>Young Adult</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>24P</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkc1u1DAUhSMEokPhAdggS2zYhPoncewNUikdKGoFoq1YWh7nesYlYwc7oeqO1-D1eJI6SqkKEoKNryV_5-j4nqJ4SvBLgnGzlzCmXJSY8JJxysvmXrEgFaMlZZTdLxaY8SrfCdspHqV0gTFpOOYPix3aVLJmpF4U_mwD6NBaMAMKFp178BvtDbTo5NMRCh4N-f10jGsIPv38_gO9AeOSC7480V-cX6OPMRhICTmPlrDVHSR06YZN1qQ-m2aj_b4H3zrjBpceFw-s7hI8uZm7xfny8OzgXXn84e3Rwf5xaXjOW0phQVKwvCVyOphgtqnbVcNWmIucXnObv5CnYMJoARZjWzVUGFwTaSq2W7yafftxtYXWgB-i7lQf3VbHKxW0U7-_eLdR6_BN1QRXgrBs8OLGIIavI6RBbV0y0HXaQxiTIqLiFeF5o_-BMklw7kdm9Pkf6EUYo8-bmKhGSCmaiSIzZWJIKYK9zU2wmopXc_EqF6-m4tUU4tndD98qfjWdATkDl66Dq387qs_vT18vscCUZC2dtSnL_Brindh_TXQNrKPJyg</recordid><startdate>201612</startdate><enddate>201612</enddate><creator>Ziedses des Plantes, C. M. P.</creator><creator>van Veen, M. J. F.</creator><creator>van der Palen, J.</creator><creator>Klaase, J. M.</creator><creator>Gielkens, H. A. J.</creator><creator>Geelkerken, R. H.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201612</creationdate><title>The Effect of Unenhanced MRI on the Surgeons’ Decision-Making Process in Females with Suspected Appendicitis</title><author>Ziedses des Plantes, C. M. P. ; van Veen, M. J. F. ; van der Palen, J. ; Klaase, J. M. ; Gielkens, H. A. J. ; Geelkerken, R. H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6231-98fe92ef6d19f6d1383f75db73b068274a6f74974a838ca8ef00f4728c0519c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Abdominal Surgery</topic><topic>Acute Appendicitis</topic><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Appendicitis</topic><topic>Appendicitis - diagnostic imaging</topic><topic>Appendicitis - surgery</topic><topic>Cardiac Surgery</topic><topic>Child</topic><topic>Decision Making</topic><topic>Diagnostic Laparoscopy</topic><topic>Female</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Magnetic Resonance Imaging Finding</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Scientific Report</topic><topic>Prospective Studies</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Thoracic Surgery</topic><topic>Vascular Surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ziedses des Plantes, C. M. P.</creatorcontrib><creatorcontrib>van Veen, M. J. F.</creatorcontrib><creatorcontrib>van der Palen, J.</creatorcontrib><creatorcontrib>Klaase, J. M.</creatorcontrib><creatorcontrib>Gielkens, H. A. J.</creatorcontrib><creatorcontrib>Geelkerken, R. H.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ziedses des Plantes, C. M. P.</au><au>van Veen, M. J. F.</au><au>van der Palen, J.</au><au>Klaase, J. M.</au><au>Gielkens, H. A. J.</au><au>Geelkerken, R. H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effect of Unenhanced MRI on the Surgeons’ Decision-Making Process in Females with Suspected Appendicitis</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2016-12</date><risdate>2016</risdate><volume>40</volume><issue>12</issue><spage>2881</spage><epage>2887</epage><pages>2881-2887</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
This prospective study evaluated the impact of the results of unenhanced magnetic resonance imaging (MRI) on the surgeon’s diagnosis of acute appendicitis in potentially fertile females.
Methods
112 female patients, aged 12–55, with suspected appendicitis underwent MRI of the abdomen. At three defined intervals; admission and clinical re-evaluation before and after revealing the MRI results, the surgeon recorded the attendance of each patient in operative treatment, observation or discharge. Appendicitis was confirmed or declined by pathology or by telephone follow-up in case of non-intervention.
Findings
Appendicitis was confirmed in 29 of 112 patients. At admission the surgeon’s disposition had a sensitivity of 97 % and specificity of 29 %. After knowing the MRI results, sensitivity was 97 % and specificity 64 %. The sensitivity and specificity of MRI alone were 89 and 100 %, with a negative and positive predictive value of 96 and 100 %, respectively.
Conclusion
We believe that MRI should perhaps be standard in all female patients during their reproductive years with suspected appendicitis. It avoids an operation in 32 % of cases and allows earlier planning for patients with an equivocal clinical picture. Trial number: OND1292733 (Narcis.nl).</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>27495315</pmid><doi>10.1007/s00268-016-3626-7</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Abdominal Surgery Acute Appendicitis Acute Disease Adolescent Adult Appendicitis Appendicitis - diagnostic imaging Appendicitis - surgery Cardiac Surgery Child Decision Making Diagnostic Laparoscopy Female General Surgery Humans Magnetic Resonance Imaging Magnetic Resonance Imaging - methods Magnetic Resonance Imaging Finding Medicine Medicine & Public Health Middle Aged Original Scientific Report Prospective Studies Surgeons Surgery Thoracic Surgery Vascular Surgery Young Adult |
| title | The Effect of Unenhanced MRI on the Surgeons’ Decision-Making Process in Females with Suspected Appendicitis |
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