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Diagnostic Performance of Magnetic Resonance Imaging for Detection of Acute Appendicitis in Pregnantwomen; a Systematic Review Andmeta-Analysis Publisher



Motavaselian M1 ; Bayati F2 ; Amanibeni R3 ; Khalaji A4 ; Haghverdi S5 ; Abdollahi Z6 ; Sarrafzadeh A7 ; Manzelat AMR3 ; Rigi A8 ; Bahri RA9 ; Nakhaee Z10 ; Fadaei M11 ; Falaverjani HG12 ; Malekpourdehkordi S13 Show All Authors
Authors
  1. Motavaselian M1
  2. Bayati F2
  3. Amanibeni R3
  4. Khalaji A4
  5. Haghverdi S5
  6. Abdollahi Z6
  7. Sarrafzadeh A7
  8. Manzelat AMR3
  9. Rigi A8
  10. Bahri RA9
  11. Nakhaee Z10
  12. Fadaei M11
  13. Falaverjani HG12
  14. Malekpourdehkordi S13
  15. Hoseinpour M13
  16. Bidares M14
  17. Zandkarimi S15
  18. Ahmadi R16
  19. Beheshtiparvar D3
  20. Ahadiat SA17
  21. Farshi M3
  22. Farrokhi M18
Show Affiliations
Authors Affiliations
  1. 1. School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
  2. 2. USERN Office, Kermanshah University of Medical Sciences, Kermanshah, Iran
  3. 3. School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
  5. 5. Kermanshah University of Medical Sciences, Kermanshah, Iran
  6. 6. Ahvaz Jundishapur University ofMedical Sciences, Ahvaz, Iran
  7. 7. School of Dentistry, Arak University of Medical Sciences, Arak, Iran
  8. 8. Islamic Azad University, Zahedan Branch, Zahedan, Iran
  9. 9. Tehran University of Medical Sciences, Tehran, Iran
  10. 10. Gonabad University, Gonabad, Iran
  11. 11. School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  12. 12. Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  13. 13. Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  14. 14. Islamic Azad University of Najafabad, Najafabad, Iran
  15. 15. Faculty of Pharmacy, Islamic Azad University of Tehran Medical Sciences, Tehran, Iran
  16. 16. Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
  17. 17. Research Center of Biochemistry and Nutrition in Metabolic Disorder, Kashan University of Medical science Kashan, Iran
  18. 18. Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Archives of Academic Emergency Medicine Published:2022


Abstract

Introduction: The diagnosis of acute appendicitis (AA) in pregnant women is commonly challenging owing to the normal results of laboratory tests, organ displacement, and normal physiological inflammatory alterations. This meta-analysis aimed to investigate the accuracy of magnetic resonance imaging (MRI) in diagnosis of AA in pregnant women. Methods: Two investigators independently performed a comprehensive systematic literature search of electronic databases including MEDLINE, Cochrane Central, EMBASE, Web of Science, Scopus, and Google Scholar to identify studies that reported accuracy of MRI for diagnosis of AA in pregnant women from inception to April 1, 2022. Results: Our systematic search identified a total of 525 published papers. Finally, a total of 26 papers were included in the meta-analysis. The pooled sensitivity and specificity of MRI in diagnosis of AA in pregnant women were 0.92 (95% CI: 0.88–0.95) and 0.98 (95% CI 0.97–0.98), respectively. The pooled positive likelihood ratio and negative likelihood ratio were 29.52 (95% CI: 21.90–39.81) and 0.10 (95% CI: 0.04-0.25), respectively. The area under hierarchical summary receiver operating characteristic (HSROC) curve indicated that the accuracy ofMRI for diagnosis of AA in pregnant women is 99%. Conclusion: This meta-analysis showed that MRI has high sensitivity, specificity, and accuracy for diagnosis of AA in pregnant women and can be used as a first-line imaging modality for suspected cases of AA during pregnancy. Furthermore, it should be noted that when the result of ultrasonography is inconclusive, the use ofMRI can reduce unnecessary appendectomy in pregnant patients. © 2022, Archives of Academic Emergency Medicine. All Rights Reserved.
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