The role of radiological imaging in the diagnosis of acute appendicitis: MRI
The MRI diagnosis of acute appendicitis is generally based on the demonstration of an abnormal appendix. The presence of periappendiceal fluid collections, appendiceal phlegmon, pericecal inflammatory changes or abscesses (with or without visualization of an inflamed appendix) signifies perforation. The appendix is often curved, and thus may be seen as two round structures on a given image. Specific findings and technical details have been described. In the only two studies that have assessed its diagnostic accuracy, MRI seemed to be superior to ultrasonography, especially in cases of retrocecal and pelvic appendicitis, in obese patients and if perforation had occurred. In one study, however, MRI (unlike ultrasonography) was performed only in patients with appendicitis. Because the normal appendix cannot be identified with the use of MRI, the diagnosis of appendicitis cannot easily be excluded. Moreover, appendicoliths cannot be distinguished from air bubbles or avascular zones. Even though this modality is operator-independent, radiological expertise in assessing the appendix by MRI is limited. Other disadvantages of this technique are its high cost, the relatively long time needed for the examination, the need for intravenous contrast material (in some applications), the need to immobilize the patient (which might be problematic when dealing with children) and difficulties with claustrophobic patients. It is, therefore, unlikely that MRI will supplant ultrasonography or CT as the preferred imaging modality for the diagnosis of appendicitis. Find out more about your chance to visit the most trusted pharmacy you could ever find to get cheap alesse in the amounts required, without any need to see your health care provider first or get a prescription.