Abstract
BackgroundThe purpose of this study is to evaluate the utility of magnetic resonance imaging in the assessment of acute atraumatic abdominal pain as the first line cross sectional modality in children, so as to prevent excessive radiation exposure from computed tomography scan and to review the magnetic resonance imaging features of common acute abdominal and pelvic conditions.Results30 patients (0–18 years) underwent rapid unenhanced magnetic resonance imaging. The results of our study indicated that for the diagnosis of causes for acute abdominal pain, magnetic resonance imaging had sensitivity of 92% (95% confidence interval 73.8–97.6%) and a specificity of 80% (95% confidence interval 28.4–99.5%). The positive predictive value was 95.8% (95% confidence interval 79.9–99.3%) and negative predictive value was 67% (95% confidence interval 33.1–89.0%) which had a highly significant statistical association (p < 0.001).ConclusionUnenhanced magnetic resonance imaging is an excellent option for the initial, detailed evaluation of acute abdominal emergencies in pediatric patients because it can diagnose the whole range of presenting abnormalities which include the causes of abdominal pain warranting surgical and nonsurgical management.
Highlights
The purpose of this study is to evaluate the utility of magnetic resonance imaging in the assessment of acute atraumatic abdominal pain as the first line cross sectional modality in children, so as to prevent excessive radiation exposure from computed tomography scan and to review the magnetic resonance imaging features of common acute abdominal and pelvic conditions
Amongst the cases operated for acute abdomen, there were 3 cases of appendicitis (10%), 3 cases of ovarian torsion (10%), 2 cases of Cholelithiasis (6.7%), 2 cases of Intestinal obstruction (6.7%),1 case of intussusception, 1 of case Testicular torsion (3%), 1 case of Meckel’s diverticulum (3%) and 1 case of small gut duplication cyst (3%).The cases those were on follow up included acute 4 patients of pancreatitis (16%), 1 case of urolithiasis (3%), 2 cases of haemorrhagic cyst (6%), 2 cases of Pelvi-ureteric obstruction (6.7%), 1 case of tuboovarian abscess (3%), 1 patient of hematometra (3%) and 5 patients had no significant findings on Magnetic resonance imaging (MRI) and considered to be normal (16%)
MRI false positively detected the features of gastrointestinal tuberculosis
Summary
The purpose of this study is to evaluate the utility of magnetic resonance imaging in the assessment of acute atraumatic abdominal pain as the first line cross sectional modality in children, so as to prevent excessive radiation exposure from computed tomography scan and to review the magnetic resonance imaging features of common acute abdominal and pelvic conditions. Acute abdominal pain is generally defined as pain of non-traumatic origin with maximum duration of 5 days. Acute atraumatic emergent abdominal pain is a challenging presentation in pediatric patients, having many potential underlying causes [1]. Depending on the severity of presentation and suspicion for complications, ultrasound is currently recommended for initial assessment [3, 4], more advanced imaging may be considered for definitive assessment. CT is a highly accurate and effective cross-sectional imaging modality that is widely accessible and not user dependent [5]. There is, an increased awareness of the long-term risks of radiation
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