Diagnostic accuracy of magnetic resonance imaging for acute appendicitis during pregnancy: A systematic review.

Abstract

The purpose of this study was to present a systematic review and meta-analysis of the diagnostic accuracy of magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis in pregnant women. A literature search was conducted using the databases of PubMed, Ovid MEDLINE, EMBASE, and the Cochrane Library. The inclusion criteria were the use of MRI, as a diagnostic protocol for acute appendicitis in pregnant women, and the availability of diagnostic parameters, such as sensitivity and specificity. For each selected study, the basic demographic information and measures of diagnostic accuracy, such as sensitivity, specificity, and positive and negative predictive values, were extracted. Forest plots and summary receiver operating characteristic curves (SROC) were also obtained for diagnostic accuracy of MRI for acute appendicitis during pregnancy. A total of 22 studies and the data of 2392 patients were analyzed. Most studies had high sensitivity, with the exception of a few that had sensitivities of 0.18, 0.5, and 0.6. With respect to specificity, most results were close to 1.0, and the lowest result was 0.92. The SROC curves showed high levels of accuracy, as evidenced by an area under the curve value of 0.9922. MRI showed overall high accuracy for diagnosing acute appendicitis in pregnant women. Therefore, it is a good diagnostic tool as a first-line imaging method for suspected appendicitis in pregnant women.