title: Ultrafast 3-T MRI in the evaluation of children with acute lower abdominal pain for the detection of appendicitis.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the feasibility of ultrafast 3-T MRI in the evaluation of children with acute lower abdominal pain for the detection of appendicitis.
  
  
  METHODS
  Forty-two pediatric patients (30 girls and 12 boys; mean age, 11.5 years; age range, 4-17 years) with acute abdominal pain were prospectively studied. Ultrafast 3-T MRI was performed with a three-plane single-shot turbo spin-echo sequence and an axial T2-weighted turbo spin-echo sequence with fat suppression. All scans were performed without sedation or oral or IV contrast agent. Scan times were less than 8 minutes 45 seconds (median, 5 minutes 40 seconds). Patients underwent CT or ultrasound or both as a comparison study to the MRI examination. The MRI, CT, and ultrasound examinations were interpreted independently by four board-certified radiologists who were blinded to patient information, study interpretations, surgical pathologic findings, and final diagnosis.
  
  
  RESULTS
  Twelve of 42 cases of acute appendicitis were detected with 100% sensitivity, 99% specificity, 100% negative predictive value, and 98% positive predictive value, all of which were statistically significant (p < 0.01). The pooled and individual receiver operating characteristic curves for radiologists' interpretation of the diagnosis of acute appendicitis were greater than 0.95 in all cases (p < 0.01)
  
  
  CONCLUSIONS
  Ultrafast 3-T MRI is a feasible alternative imaging modality for the diagnosis of acute appendicitis in children, particularly in cases where ultrasound is equivocal or nondiagnostic, as an alternative to CT. Ultrafast MRI requires no sedation and no oral or IV contrast agent and has no associated radiation exposure risks.
authors.affiliation: Department of Radiology, Fletcher Allen Health Care, Burlington, VT, USA. AJohnson9@uwhealth.org
authors.forename: Alisa K
authors.initials: AK
authors.lastname: Johnson
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Filippi
authors.forename: Trevor
authors.initials: T
authors.lastname: Andrews
authors.forename: Timothy
authors.initials: T
authors.lastname: Higgins
authors.forename: Judy
authors.initials: J
authors.lastname: Tam
authors.forename: David
authors.initials: D
authors.lastname: Keating
authors.forename: Takamaru
authors.initials: T
authors.lastname: Ashikaga
authors.forename: Steven P
authors.initials: SP
authors.lastname: Braff
authors.forename: Janice
authors.initials: J
authors.lastname: Gallant
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis*; D000293:Adolescent; D001064:Appendicitis / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D014463:Ultrasonography / Q000379:methods