We want to share a Diagnostic Test Accuracy (DTA) Cochrane review about “Magnetic resonance imaging (MRI) for diagnosis of acute appendicitis”.

Objectives: To determine the diagnostic accuracy of MRI for detecting appendicitis in all patients (primary objective) and specifically in pregnant women, children, and adults (secondary objectives).  

Main results: 58 studies with 7,462 participants, including 1,980 with appendicitis and 5,482 without.

In this DTA Cochrane review, the authors conducted a comprehensive review with meta-analyses. 
They included observational studies and randomized test accuracy studies that compared the results of MRI with a reference standard in people with suspected appendicitis.

• All patients: summary sensitivity was 0.95 (95% CI: 0.94 to 0.97), and summary specificity was 0.96 (95% CI 0.95 to 0.97)
• The results indicate that, theoretically, if MRI were used in 1,000 people with suspected appendicitis, of whom 250 actually had the condition, then:
  • an estimated 250 people would have an MRI result indicating appendicitis, of whom 12 would actually not have the condition (false-positive results)
  • an estimated 750 people would have an MRI result indicating no appendicitis, of whom 30 would actually have the condition (false-negative results)
• Pregnant women, children, and adults: summary sensitivity and specificity remained high

Authors' conclusion: Based on the studies included in this review, MRI seems to be a very accurate test for appendicitis. The chance of wrongly diagnosing someone with appendicitis or missing appendicitis was less than 5%. However, as most of the included studies had problems, we cannot trust their results completely. Although MRI is promising, until better studies have been performed, we cannot firmly recommend the use of MRI for the diagnosis of appendicitis.

Access publication here: https://doi.org/10.1002/14651858.CD012028.pub2