Iranian Journal of Radiology

Published by: Kowsar

Added Value of Diffusion-Weighted MR Imaging to Non-Enhanced CT in the Evaluation of Acute Appendicitis

Oguzhan Ozdemir 1 , * , Yavuz Metin 1 , Nurgul Orhan Metin 1 , Ozlem Bilir 2 , Ozcan Yavasi 2 and Ali Kupeli 3
Authors Information
1 Department of Radiology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
2 Department of Emergency, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
3 Department of Radiology, Mus Public Hospital, Mus, Turkey
Article information
  • Iranian Journal of Radiology: January 2018, 15 (1); e14181
  • Published Online: November 9, 2017
  • Article Type: Research Article
  • Received: August 13, 2016
  • Revised: October 2, 2017
  • Accepted: October 17, 2017
  • DOI: 10.5812/iranjradiol.14181

To Cite: Ozdemir O, Metin Y, Orhan Metin N, Bilir O, Yavasi O, et al. Added Value of Diffusion-Weighted MR Imaging to Non-Enhanced CT in the Evaluation of Acute Appendicitis, Iran J Radiol. 2018 ; 15(1):e14181. doi: 10.5812/iranjradiol.14181.

Copyright © 2017, Iranian Journal of Radiology. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited
1. Background
2. Objectives
3. Patients and Methods
4. Results
5. Discussion
  • 1. Cartwright SL, Knudson MP. Diagnostic imaging of acute abdominal pain in adults. Am Fam Physician. 2015;91(7):452-9. [PubMed: 25884745].
  • 2. Singh A, Danrad R, Hahn PF, Blake MA, Mueller PR, Novelline RA. MR imaging of the acute abdomen and pelvis: acute appendicitis and beyond. Radiographics. 2007;27(5):1419-31. doi: 10.1148/rg.275065021. [PubMed: 17848700].
  • 3. Pedrosa I, Rofsky NM. MR imaging in abdominal emergencies. Radiol Clin North Am. 2003;41(6):1243-73. [PubMed: 14661669].
  • 4. Lane JS, Schmit PJ, Chandler CF, Bennion RS, Thompson JJ. Ileocecectomy is definitive treatment for advanced appendicitis. Am Surg. 2001;67(12):1117-22. [PubMed: 11768813].
  • 5. Thompson JJ, Bennion RS, Schmit PJ, Hiyama DT. Cecectomy for complicated appendicitis. J Am Coll Surg. 1994;179(2):135-8. [PubMed: 8044380].
  • 6. Bixby SD, Lucey BC, Soto JA, Theysohn JM, Ozonoff A, Varghese JC. Perforated versus nonperforated acute appendicitis: accuracy of multidetector CT detection. Radiology. 2006;241(3):780-6. doi: 10.1148/radiol.2413051896. [PubMed: 17114626].
  • 7. Drake FT, Florence MG, Johnson MG, Jurkovich GJ, Kwon S, Schmidt Z, et al. Progress in the diagnosis of appendicitis: a report from Washington State's Surgical Care and Outcomes Assessment Program. Ann Surg. 2012;256(4):586-94. doi: 10.1097/SLA.0b013e31826a9602. [PubMed: 22964731].
  • 8. Humes DJ, Simpson J. Acute appendicitis. BMJ. 2006;333(7567):530-4. doi: 10.1136/bmj.38940.664363.AE. [PubMed: 16960208].
  • 9. Puylaert JB. Ultrasonography of the acute abdomen: gastrointestinal conditions. Radiol Clin North Am. 2003;41(6):1227-42. vii. [PubMed: 14661668].
  • 10. Doria AS, Moineddin R, Kellenberger CJ, Epelman M, Beyene J, Schuh S, et al. US or CT for Diagnosis of Appendicitis in Children and Adults? A Meta-Analysis. Radiology. 2006;241(1):83-94. doi: 10.1148/radiol.2411050913. [PubMed: 16928974].
  • 11. Levine CD, Aizenstein O, Wachsberg RH. Pitfalls in the CT diagnosis of appendicitis. Br J Radiol. 2004;77(921):792-9. doi: 10.1259/bjr/95663370. [PubMed: 15447972].
  • 12. Kim K, Kim YH, Kim SY, Kim S, Lee YJ, Kim KP, et al. Low-dose abdominal CT for evaluating suspected appendicitis. N Engl J Med. 2012;366(17):1596-605. doi: 10.1056/NEJMoa1110734. [PubMed: 22533576].
  • 13. Ives EP, Sung S, McCue P, Durrani H, Halpern EJ. Independent predictors of acute appendicitis on CT with pathologic correlation. Acad Radiol. 2008;15(8):996-1003. doi: 10.1016/j.acra.2008.02.009. [PubMed: 18620120].
  • 14. Kim HC, Yang DM, Jin W, Park SJ. Added diagnostic value of multiplanar reformation of multidetector CT data in patients with suspected appendicitis. Radiographics. 2008;28(2):393-405. discussion 405-6. doi: 10.1148/rg.282075039. [PubMed: 18349447].
  • 15. Moore WA, Khatri G, Madhuranthakam AJ, Sims RD, Pedrosa I. Added value of diffusion-weighted acquisitions in MRI of the abdomen and pelvis. AJR Am J Roentgenol. 2014;202(5):995-1006. doi: 10.2214/AJR.12.9563. [PubMed: 24758652].
  • 16. Koh DM, Collins DJ. Diffusion-weighted MRI in the body: applications and challenges in oncology. AJR Am J Roentgenol. 2007;188(6):1622-35. doi: 10.2214/AJR.06.1403. [PubMed: 17515386].
  • 17. Rathod SB, Kumbhar SS, Nanivadekar A, Aman K. Role of diffusion-weighted MRI in acute pyelonephritis: a prospective study. Acta Radiol. 2015;56(2):244-9. doi: 10.1177/0284185114520862. [PubMed: 24443116].
  • 18. Stoker J, van Randen A, Lameris W, Boermeester MA. Imaging patients with acute abdominal pain. Radiology. 2009;253(1):31-46. doi: 10.1148/radiol.2531090302. [PubMed: 19789254].
  • 19. Bruegel M, Gaa J, Waldt S, Woertler K, Holzapfel K, Kiefer B, et al. Diagnosis of hepatic metastasis: comparison of respiration-triggered diffusion-weighted echo-planar MRI and five t2-weighted turbo spin-echo sequences. AJR Am J Roentgenol. 2008;191(5):1421-9. doi: 10.2214/AJR.07.3279. [PubMed: 18941080].
  • 20. Sumi M, Van Cauteren M, Nakamura T. MR microimaging of benign and malignant nodes in the neck. AJR Am J Roentgenol. 2006;186(3):749-57. doi: 10.2214/AJR.04.1832. [PubMed: 16498102].
  • 21. Lubarsky M, Kalb B, Sharma P, Keim SM, Martin DR. MR imaging for acute nontraumatic abdominopelvic pain: rationale and practical considerations. Radiographics. 2013;33(2):313-37. doi: 10.1148/rg.332125116. [PubMed: 23479698].
  • 22. Qayyum A. Diffusion-weighted imaging in the abdomen and pelvis: concepts and applications. Radiographics. 2009;29(6):1797-810. doi: 10.1148/rg.296095521. [PubMed: 19959522].
  • 23. Le Bihan D, Breton E, Lallemand D, Aubin ML, Vignaud J, Laval-Jeantet M. Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging. Radiology. 1988;168(2):497-505. doi: 10.1148/radiology.168.2.3393671. [PubMed: 3393671].
  • 24. Oto A, Zhu F, Kulkarni K, Karczmar GS, Turner JR, Rubin D. Evaluation of diffusion-weighted MR imaging for detection of bowel inflammation in patients with Crohn's disease. Acad Radiol. 2009;16(5):597-603. doi: 10.1016/j.acra.2008.11.009. [PubMed: 19282206].
  • 25. Kwee TC, Takahara T, Ochiai R, Nievelstein RA, Luijten PR. Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS): features and potential applications in oncology. Eur Radiol. 2008;18(9):1937-52. doi: 10.1007/s00330-008-0968-z. [PubMed: 18446344].
  • 26. Muraoka N, Uematsu H, Kimura H, Imamura Y, Fujiwara Y, Murakami M, et al. Apparent diffusion coefficient in pancreatic cancer: characterization and histopathological correlations. J Magn Reson Imaging. 2008;27(6):1302-8. doi: 10.1002/jmri.21340. [PubMed: 18504750].
  • 27. Inci E, Kilickesmez O, Hocaoglu E, Aydin S, Bayramoglu S, Cimilli T. Utility of diffusion-weighted imaging in the diagnosis of acute appendicitis. Eur Radiol. 2011;21(4):768-75. doi: 10.1007/s00330-010-1981-6. [PubMed: 20924585].
  • 28. Atema JJ, van Rossem CC, Leeuwenburgh MM, Stoker J, Boermeester MA. Scoring system to distinguish uncomplicated from complicated acute appendicitis. Br J Surg. 2015;102(8):979-90. doi: 10.1002/bjs.9835. [PubMed: 25963411].
  • 29. Pickhardt PJ, Lawrence EM, Pooler BD, Bruce RJ. Diagnostic performance of multidetector computed tomography for suspected acute appendicitis. Ann Intern Med. 2011;154(12):789-96. W-291. doi: 10.7326/0003-4819-154-12-201106210-00006. [PubMed: 21690593].
  • 30. Kato H, Kanematsu M, Uchiyama M, Yano R, Furui T, Morishige K. Diffusion-weighted imaging of ovarian torsion: usefulness of apparent diffusion coefficient (ADC) values for the detection of hemorrhagic infarction. Magn Reson Med Sci. 2014;13(1):39-44. [PubMed: 24492742].
  • 31. Lee NK, Kim S, Kim KH, Suh DS, Kim TU, Han GJ, et al. Diffusion-weighted magnetic resonance imaging in the differentiation of endometriomas from hemorrhagic cysts in the ovary. Acta Radiol. 2016;57(8):998-1005. doi: 10.1177/0284185115609805. [PubMed: 26543051].

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