Magnetic resonance imaging versus computed tomography and ultrasound for the diagnosis of female pelvic pathology.
CT
MRI
Ovarian cyst
Ovarian torsion
Pelvic pain
Journal
Emergency radiology
ISSN: 1438-1435
Titre abrégé: Emerg Radiol
Pays: United States
ID NLM: 9431227
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
14
12
2020
accepted:
25
02
2021
pubmed:
18
3
2021
medline:
26
11
2021
entrez:
17
3
2021
Statut:
ppublish
Résumé
We sought to determine the diagnostic accuracy of magnetic resonance (MR) imaging compared with computed tomography (CT) and ultrasound (US) when evaluating for five common pelvic pathologies among women presenting to the emergency department (ED) with right lower quadrant abdominal pain. This prospective, single-center study was conducted at an academic ED as a sub-analysis of a direct comparison of the diagnostic accuracy of CT and MR in the evaluation of appendicitis. Patients were eligible for participation in the parent study if they were at least 12 years old and had a CT performed for evaluation of possible appendicitis. In the current study, only female patients who also underwent pelvic US were included. Three radiologists independently interpreted each MR examination specifically for the presence of pelvic pathology, knowing that patients had initially undergone imaging evaluation for possible appendicitis. The determination of an independent expert panel of two radiologists and one emergency physician based on surgical pathology, comprehensive chart review, clinical information, and follow-up phone calls served as the reference standard. Test characteristics of MR, CT, and US were calculated based on this; the main outcome measure was the summary sensitivity and specificity of MR versus CT and US. Forty-one participants were included with a mean age of 27.6 ± 10.8 years. The MR consensus interpretation had an overall sensitivity and specificity of 57.1% (CI 38.8-75.5%) and 97.2% (CI 94.7-99.6%) respectively, for detecting any of the five pelvic pathologies. By comparison, CT exhibited sensitivity and specificity of 66.7% (CI 50.0-83.5%) and 98.3% (CI 96.4-100.0%) while it was 64.3% (CI 46.5-82.0%) and 97.7% (CI 95.6-99.9%) for US, respectively. No significant differences were identified when comparing these modalities. Overall, Fleiss' kappa interrater reliability value for MR interpretation was 0.75, corresponding to substantial agreement between the three readers. In women who might otherwise undergo multiple imaging tests to evaluate gastrointestinal versus pelvic pathologies, our data suggest that MR may be an acceptable first-line imaging test.
Identifiants
pubmed: 33730220
doi: 10.1007/s10140-021-01923-4
pii: 10.1007/s10140-021-01923-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
789-796Subventions
Organisme : NIDDK NIH HHS
ID : K08 DK111234
Pays : United States
Organisme : NIDDK NIH HHS
ID : K24 DK102595
Pays : United States
Organisme : NCATS NIH HHS
ID : KL2 TR000428
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000427
Pays : United States
Organisme : NIDDK NIH HHS
ID : K08 DK111234
Pays : United States
Organisme : NIDDK NIH HHS
ID : K24 DK102595
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000427
Pays : United States
Organisme : NCATS NIH HHS
ID : KL2 TR000428
Pays : United States
Informations de copyright
© 2021. American Society of Emergency Radiology.
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