1Gynecology and Obstetrics Institution, Faculty of Medicine, Zabol University of Medical Sciences, Zabol, Islamic Republic of Iran.
2Student Research Committee, Faculty of Medicine, Zabol University of Medical Sciences, Zabol, Islamic Republic of Iran.
World J Emerg Surg. 2019 Jul 22;14:37. doi: 10.1186/s13017-019-0254-1. eCollection 2019.
The aim of this systematic review and meta-analysis was to evaluate the clinical use of MRI for the evaluation of acute appendicitis during pregnancy.
The searches were conducted by two independent researchers (MK, MS) to find the relevant studies published from 1/1/2009 until end of 30/12/2018. We searched for published literature in the English language in MEDLINE via PubMed, EMBASETM via Ovid, The Cochrane Library, and Trip database. For literature published in other languages, we searched national databases (Magiran and SID), KoreaMed, and LILACS. The keywords used in the search strategy are Pregnancy [MeSH], Pregnant [MeSH] OR-Magnetic resonance imaging [MeSH] OR-Appendicitis [MeSH] OR-Ultrasound, [MeSH] OR, imaging, MRI [MeSH] OR"،" and Right lower quadrant pain [MeSH]. The risk of bias of every article was evaluated by using QUADAS-2. On the basis of the results from the 2 × 2 tables, pooled measures for sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curves (AUC) along with their 95% confidence intervals (CIs) were calculated using the DerSimonian Lair methodology.
As many as 1164 studies were selected. After analyzing the correspondence of the studies with the required criteria, 19 studies were selected for the final review. For appendicitis in pregnancy, the MRI sensitivity was 91.8% at the 95% confidence interval of (95% CI 87.7-94.9%). At the confidence interval of 95%, the specificity was 97.9% (95% CI 0.97.2-100%). The risk of bias in the studies conducted was measured using the QUADAS-2 tool.
MRI has high sensitivity and specificity (91.8%, 97.9% respectively) for the diagnosis of acute appendicitis in pregnant patients with clinically suspected appendicitis. It is an excellent imaging technique in many instances, which does not expose a fetus, or the mother, to ionizing radiation, making it an excellent option for pregnant patients with suspected acute appendicitis.
本系统评价和荟萃分析的目的是评估 MRI 在妊娠期间评估急性阑尾炎的临床应用。
两位独立研究人员（MK、MS）进行了检索，以查找从 2009 年 1 月 1 日至 2018 年 12 月 30 日发表的相关研究。我们通过 PubMed 在 MEDLINE 中、通过 Ovid 在 EMBASE 中、在 Cochrane 图书馆和 Trip 数据库中搜索已发表的文献。对于以其他语言发表的文献，我们在国内数据库（Magiran 和 SID）、韩国医学文献信息服务系统和 LILACS 中进行了搜索。搜索策略中使用的关键词是妊娠 [MeSH]、孕妇 [MeSH] 或-磁共振成像 [MeSH]、阑尾炎 [MeSH]、超声 [MeSH]、成像、MRI [MeSH] 或“”和右下象限疼痛 [MeSH]。使用 QUADAS-2 评估每篇文章的偏倚风险。根据 2×2 表的结果，使用 DerSimonian Lair 方法计算合并敏感度、特异度、诊断比值比（DOR）和曲线下面积（AUC）及其 95%置信区间（CI）。
共选择了 1164 项研究。在分析研究与所需标准的对应关系后，选择了 19 项研究进行最终审查。对于妊娠合并阑尾炎，MRI 敏感度为 91.8%，95%置信区间为（95%CI 87.7-94.9%）。在 95%置信区间内，特异度为 97.9%（95%CI 0.97.2-100%）。使用 QUADAS-2 工具测量研究中的偏倚风险。
MRI 对有临床疑似阑尾炎的孕妇的急性阑尾炎诊断具有较高的敏感度和特异度（分别为 91.8%、97.9%）。在许多情况下，它是一种极好的影像学技术，不会使胎儿或母亲暴露于电离辐射，因此对于疑似急性阑尾炎的孕妇是一种极好的选择。
