title: The Effect of Unenhanced MRI on the Surgeons' Decision-Making Process in Females with Suspected Appendicitis.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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).
authors: Department of Radiology, Medical Spectrum Twente, PO Box 50000, 7500 KA, Enschede, The Netherlands.|Department of Radiology, SHO Center for Medical Diagnostics, 6883 JP, Velp, The Netherlands.
authors: C M P
authors: CMP
authors: Ziedses des Plantes
authors: Department of Surgery, Medical Spectrum Twente, PO Box 50000, 7500 KA, Enschede, The Netherlands. martin.vanveen@gmail.com.|Department of Surgery, UMCG, PO Box 30001, 9700 RB, Groningen, The Netherlands. martin.vanveen@gmail.com.
authors: M J F
authors: MJF
authors: van Veen
authors: Department of Epidemiology, Medical Spectrum Twente, PO Box 50000, 7500 KA, Enschede, The Netherlands.
authors: J
authors: J
authors: van der Palen
authors: Department of Surgery, Medical Spectrum Twente, PO Box 50000, 7500 KA, Enschede, The Netherlands.
authors: J M
authors: JM
authors: Klaase
authors: Department of Radiology, Medical Spectrum Twente, PO Box 50000, 7500 KA, Enschede, The Netherlands.
authors: H A J
authors: HAJ
authors: Gielkens
authors: Department of Surgery, Medical Spectrum Twente, PO Box 50000, 7500 KA, Enschede, The Netherlands.|Faculty of Science and Technology, Experimental Centre of Technical Medicine, University of Twente, PO Box 217, 7500 AE, Enschede, The Netherlands.
authors: R H
authors: RH
authors: Geelkerken
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001064:Appendicitis / Q000000981:diagnostic imaging / Q000601:surgery*; D002648:Child; D003657:Decision Making; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D066231:Surgeons; D055815:Young Adult