Evan James Zucker MD, Presenter: Nothing to Disclose

Shreyas Shreenivas Vasanawala MD, PhD, Abstract Co-Author: Research collaboration, General Electric Company Stockholder, Morpheus Imaging, Inc

1. To describe our institutional imaging algorithm and protocol for emergency MRI in pediatric patients with suspected appendicitis. 2. To illustrate examples of the normal and abnormal appendix by MRI, including the perforated appendix. 3. To demonstrate the broad spectrum of pathology that may mimic appendicitis and yet be accurately diagnosed by MRI.

Beginning in October 2013, our institution began performing emergency MRI in place of CT as the second-line modality for imaging pediatric patients with suspected appendicitis and equivocal ultrasound. The imaging algorithm and MR protocol are discussed. Illustrative cases of the normal and abnormal appendix are presented, including examples of the perforated appendix and related complications such as abscess formation. A broad spectrum of alternative diagnoses that may be accurately diagnosed by MRI are demonstrated, including: mesenteric adenitis, gastroenteritis, enema-induced free fluid, Crohn’s disease, pyelonephritis, renal transplant rejection, congenital renal duplication and malrotation, pancreatitis, ovulatory free fluid, hemorrhagic ovarian cyst, paratubal cyst, rectus femoris avulsion, and abdominal wall edema due to asthmatic cough. In summary, MRI is highly useful for evaluating children with suspected appendicitis and elucidating alternative causes of pain.

http://abstract.rsna.org/uploads/2014/14004437/14004437_5hb3.pdf

Zucker, E, Vasanawala, S, MRI for Pediatric Appendicitis: Normal, Abnormal, and Alternative Diagnoses.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14004437.html