Imaging of appendicitis in adults.
Three imaging modalities are available for the diagnosis of acute appendicitis: ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI). Transabdominal ultrasound should be the first-line imaging test. Abdominal CT is superior to US and is required immediately in patients with atypical clinical presentation of appendicitis and suspected perforation. However, low-dose unenhanced CT is equal to standard-dose CT with intravenous contrast agents in the detection of five signs of acute appendicitis (thickened appendiceal wall more than 2 mm, cross-sectional diameter greater than 6 mm, periappendicitis, abscess, and appendicolith). MRI is necessary in pregnant women and young adults. This review illustrates the principles of state-of-the-art imaging techniques and their clinical relevance.


CONCLUSIONS
• US is the basic diagnostic method in case of suspected appendicitis.• CT is necessary in patients with atypical presentation of appendicitis.• MRI should be the first-line imaging test in pregnant women.
Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Hamburg.
M
M
Karul
Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Hamburg.
C
C
Berliner
Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Hamburg.
S
S
Keller
Department of General, Visceral- and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg.
T Y
TY
Tsui
Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Hamburg.
J
J
Yamamura
D000006:Abdomen, Acute / Q000209:etiology; D000328:Adult; D001064:Appendicitis / Q000175:diagnosis* / Q000601:surgery; D001065:Appendix / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography / Q000379:methods*