Evidence map›Paper›PMID 38753209›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2024

Magnetic resonance imaging for acute appendicitis in pregnancy: can clinical scores predict when imaging is needed?

Noam Kahana, Elad Boaz, Mariya Neymark, Hayim Gilshtein, Yossi Freier Dror, Ofer Benjaminov, Petachia Reissman, James Tankel

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Letter to the editor regarding the Alvarado and AIR score in pregnant women.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Noam Kahana *Department of General Surgery, Shaare Zedek medical center, the Hebrew University School of Medicine, Jerusalem, Israel.
Elad Boaz *Department of General Surgery, Shaare Zedek medical center, the Hebrew University School of Medicine, Jerusalem, Israel.
Mariya NeymarkDepartment of General Surgery, Rambam Health Care Center, Haifa, Israel.
Hayim GilshteinDepartment of General Surgery, Rambam Health Care Center, Haifa, Israel.
Yossi Freier DrorMashav Applied Research, Jerusalem, Israel.
Ofer BenjaminovDepartment of Radiology, Shaare Zedek Medical Center, the Hebrew University School of Medicine, Jerusalem, Israel.
Petachia ReissmanDepartment of General Surgery, Shaare Zedek medical center, the Hebrew University School of Medicine, Jerusalem, Israel.
James TankelDepartment of General Surgery, Shaare Zedek medical center, the Hebrew University School of Medicine, Jerusalem, Israel. jamest@szmc.org.il.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAdvanced imaging may augment the diagnostic milieux for presumed acute appendicitis (AA) during pregnancy, however it is not clear when such imaging modalities are indicated. The aim of this study was to assess the sensitivity and specificity of clinical scoring systems with the findings on magnetic resonance imaging (MRI) of AA in pregnant patients.

methodsA retrospective cohort study between 2019 and 2021 was performed in two tertiary level centers. Pregnant patients presenting with suspected AA and non-diagnostic trans-abdominal ultrasound who underwent MRI as part of their evaluation were identified. Patient demographics, parity, gestation, presenting signs, and symptoms were documented. The Alvarado and Appendicitis Inflammatory Response (AIR) score for each patient were calculated and correlated with clinical and MRI findings. Univariate analysis was used to identify factors associated with AA on MRI.

resultsOf the 255 pregnant patients who underwent MRI, 33 (13%) had findings of AA. On univariate analysis, presentation during the second/third trimester, migration of pain, vomiting and RLQ tenderness correlated with MRI findings of AA. Whilst 5/77 (6.5%) of patients with an Alvarado score ≤4 had signs of AA on MRI, a score of ≥5 had a sensitivity, specificity, negative and positive predictive value of 84.8%, 36.6%, 94.0% and 17.2%. For an AIR score ≥ 5, this was 78.8%, 41.5%, 93.0%, and 16.7%, respectively.

conclusionsWhilst clinical scoring systems may be useful in identifying which pregnant patients require MRI to be performed when AA is suspected, the low sensitivity implies further research is needed to refine the use of this valuable resource.

Indexed as

AppendicitisMagnetic Resonance ImagingPregnancy ComplicationsSensitivity and SpecificityAcute DiseaseAdultFemaleHumansPredictive Value of TestsPregnancyRetrospective StudiesAcute appendicitisClinical scoringDiagnosisMRIPregnancy

Identifiers

PMID38753209
PMCPMC11666636

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.