Abdominal radiology (New York)
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Multicenter Study
MRI for appendicitis in pregnancy: is seeing believing? clinical outcomes in cases of appendix nonvisualization.
The primary objective of this study was to determine the clinical outcomes in cases of appendix nonvisualization with MRI in pregnant patients with suspected appendicitis and the implications of appendix nonvisualization for excluding appendicitis. ⋯ Despite only moderate level of interobserver agreement for appendix visualization, appendix nonvisualization on MRI in pregnant patients with suspected appendicitis confers a significant reduction in the risk of appendicitis compared to all comers as long as the study is adequate diagnostic quality and there are no secondary signs of appendicitis present.
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Pregnant patients can receive allergy premedication prior to a contrast-enhanced computed tomography exam if the exam is indicated. The risks and benefits of allergy premedication for pregnant patients will be discussed, as well as imaging strategies for the pregnant patient with a contrast allergy. Alternative imaging including ultrasound, noncontrast magnetic resonance imaging, or noncontrast computed tomography can be diagnostic depending on the clinical scenario and is usually preferred, allowing physicians to avoid giving allergy premedication in pregnancy, a 13 h delay, and risking a breakthrough reaction.