{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T14:59:44Z","timestamp":1775487584531,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,1,4]],"date-time":"2019-01-04T00:00:00Z","timestamp":1546560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Noncontrast MRI has been shown to be feasible in children with postappendectomy abscesses and helps guide clinical management, but its role in preoperative appendiceal abscesses is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To determine the cost\u2010effectiveness and impact on clinical management of noncontrast MRI in pediatric patients with suspected appendiceal abscess, both pre\u2010 and postappendectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Type<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>In all, 82 children under the age of 18 years with suspected appendiceal abscess on ultrasound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Field Strength\/Sequence<\/jats:title><jats:p>Diffusion\u2010weighted imaging and T<jats:sub>2<\/jats:sub>\u2010weighted single\u2010shot fast spin\u2010echo imaging of the abdomen and pelvis at 1.5T and 3T.<\/jats:p><\/jats:sec><jats:sec><jats:title>Assessment<\/jats:title><jats:p>The presence, location, size, and apparent diffusion coefficient (ADC) of fluid collections and the presence of a drainage path was noted by three pediatric radiologists. Imaging time, completeness of the exam, and impact on clinical management was recorded. The incremental cost\u2010effectiveness ratio was calculated for MRI relative to CT, taking into account hospital charges, radiation exposure, and risk of adverse reaction to iodinated contrast.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Descriptive statistics were used. Intraclass correlation coefficient and Fleiss' kappa were used to assess interobserver variation. Proportions were compared using Fisher's exact test (statistical significance at <jats:italic>P<\/jats:italic> &lt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>MRI confirmed the presence of collections in most cases, with alternative diagnosis established in 10 patients (Tubo\u2010ovarian abscess <jats:italic>n<\/jats:italic> = 7, Crohn's disease, ileal anastomotic leak, and Birkitts lymphoma each <jats:italic>n<\/jats:italic> = 1). MRI showed the presence of a safe drainage pathway in 92\u201397% of pelvic abscesses and 86\u201398% of abdominal abscesses compared with 7\u201310% and 75\u201381%, respectively, for ultrasound. MR was cost\u2010effective compared with CT, taking into account the direct charges, risk of radiation induced cancer, and adverse reaction to iodinated contrast.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>Noncontrast MR is cost\u2010effective and affects clinical management in a significant proportion of children with suspected appendiceal abscesses.<\/jats:p><jats:p><jats:bold>Level of Evidence<\/jats:bold>: 5<\/jats:p><jats:p><jats:bold>Technical Efficacy<\/jats:bold>: Stage 6<\/jats:p><jats:p>J. Magn. Reson. Imaging 2019.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.26624","type":"journal-article","created":{"date-parts":[[2019,1,4]],"date-time":"2019-01-04T19:04:03Z","timestamp":1546628643000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Clinical impact and cost\u2010effectiveness of noncontrast MRI in the evaluation of suspected appendiceal abscesses in children"],"prefix":"10.1002","volume":"49","author":[{"given":"Nishard","family":"Abdeen","sequence":"first","affiliation":[{"name":"Department of Medical Imaging Children's Hospital of Eastern Ontario  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fozia","family":"Naz","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Children's Hospital of Eastern Ontario  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhys","family":"Linthorst","sequence":"additional","affiliation":[{"name":"Faculty of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usman","family":"Khan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ottawa  Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo Caro","family":"Dominguez","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Children's Hospital of Eastern Ontario  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaldoun","family":"Koujok","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Children's Hospital of Eastern Ontario  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos","family":"Bettoli","sequence":"additional","affiliation":[{"name":"Department of Surgery Children's Hospital of Eastern Ontario  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nazih","family":"Shenouda","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Children's Hospital of Eastern Ontario  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,1,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2012.09.019"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0032-1330062"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-5245-7"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31811f3f9f"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2009.08.011"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-016-3557-3"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.14132206"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-017-3860-7"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2018.02.078"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.2217\/iim.12.9"},{"key":"e_1_2_6_12_1","unstructured":"Ontario Health Insurance Plan Infobulletin NA 84. Interprovincial outpatient rates effective April 1 2018.www.health.gov.on.ca\/en\/pro\/programs\/ohip\/bulletins\/na_84\/na_84.pdfaccessed Nov 22 2018."},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2013.311"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26628"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.06.1328"},{"key":"e_1_2_6_16_1","unstructured":"Ontario Health Insurance Plan Infobulletin NA 84 Schedule A. Interprovincial per diem rates for in\u2010patient services effective April 1 2018.www.health.gov.on.ca\/en\/pro\/programs\/ohip\/bulletins\/na_84\/schedule_a.pdfaccessed Nov 22 2018."},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejro.2016.08.005"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00411-012-0405-1"}],"container-title":["Journal of Magnetic Resonance Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjmri.26624","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmri.26624","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jmri.26624","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmri.26624","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T11:24:23Z","timestamp":1694345063000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmri.26624"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,4]]},"references-count":17,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1002\/jmri.26624"],"URL":"https:\/\/doi.org\/10.1002\/jmri.26624","archive":["Portico"],"relation":{},"ISSN":["1053-1807","1522-2586"],"issn-type":[{"value":"1053-1807","type":"print"},{"value":"1522-2586","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,4]]},"assertion":[{"value":"2018-09-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}