MRI in Adult Clinic Proven to Be Effective in Diagnosing Pediatric Appendicitis

Researchers have found that unenhanced magnetic resonance imaging (MRI) for child patients with appendicitis in an adult clinical setting is effective and accurate, according to a study recently published in the American College of Roentgenology.

Taking into account positive outcomes using ultrasound and CT to evaluate children with appendicitis, researchers from the San Antonio Military Medical Center in Fort Sam in Houston, Texas wanted to see if MRI could be practical procedure for diagnosing the emergency medical condition.

The study authors looked at pediatric patient data between 2012 and 2016 and found that 528 children patients underwent MRI after equivocal ultrasound evaluation. Out of that group, over 21 percent of patients actually had a normal appendix or didn’t have problems with the appendix, and 10.4 percent had “surgically proven or pathologically proven appendicitis.” According to HealthImaging, “MRI achieved a sensitivity of 96.4 percent and a specificity of 98.9 percent.”

Administering MRI on children patients in adult-clinic settings could be a challenge for radiologists, as the researchers found that non-pediatric radiologists were “less familiar and less comfortable” with reading images of child body scans. According to lead author James Covelli, MD, many adult-focused radiologists have minimal training in this diagnosing children with appendicitis, an issue that appears to be even more problematic given that the protocol for non-pregnant adult patients with possible appendicitis is to undergo CT, not MRI.

To help educate these radiologists on the effectiveness of this alternative, the researchers recommend introducing “image-rich, evidence-based” campaigns, lectures, grand rounds, and conferences in the pediatric radiology department on how to confidently implement MRI.