• European radiology · Apr 2011

    Utility of diffusion-weighted imaging in the diagnosis of acute appendicitis.

    • Ercan Inci, Ozgur Kilickesmez, Elif Hocaoglu, Sibel Aydin, Sibel Bayramoglu, and Tan Cimilli.
    • Department of Radiology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey. ercan@inci.com
    • Eur Radiol. 2011 Apr 1; 21 (4): 768-75.

    ObjectivesTo evaluate the value of diffusion-weighted MRI (DWI) in the diagnosis of acute appendicitis.Methods119 patients with acute appendicitis and 50 controls were enrolled in this prospective study. DWI was obtained with b factors 0, 500 and 1000 s/mm² and were assessed with a visual scoring system by two radiologists followed by quantitative evaluation of the DW images and ADC maps.ResultsHistopathology revealed appendicitis in 79/92 patients (78%) who had undergone surgery. On visual evaluation, except for one patient with histopathologically proven appendicitis all inflamed appendixes were hyperintense on DWI (98.7%). Quantitative evaluation with DW signal intensities and ADC values revealed a significant difference with normal and inflamed appendixes (p < 0.001). The best discriminative parameter was signal intensity (b 500). With a cut-off value of 56 for the signal intensity the ratio had a sensitivity of 99% and a specificity of 97%. The cut-off ADC value at 1.66 mm²/s had a sensitivity of 97% and a specificity of 99%.ConclusionDWI is a valuable technique for the diagnosis of acute appendicitis with both qualitative and quantitative evaluation. DWI increases the conspicuity of the inflamed appendix. We recommend using DWI to diagnose acute appendicitis.

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