{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T03:55:30Z","timestamp":1783137330729,"version":"3.54.6"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,1,14]],"date-time":"2016-01-14T00:00:00Z","timestamp":1452729600000},"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":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2016,2]]},"abstract":"Abstract<\/jats:title>Objectives<\/jats:title>Suggestive radiographic studies with nonvisualization of the appendix can present a challenge to clinicians in the evaluation of pediatric abdominal pain. The primary objective of this study was to quantify the accuracy of magnetic resonance imaging (MRI<\/jats:styled-content>) and of ultrasound (US<\/jats:styled-content>) in the setting of nonvisualization of the appendix. Secondary objectives reported include sensitivity of MRI<\/jats:styled-content> and US<\/jats:styled-content> overall and correlation between MRI<\/jats:styled-content> and US<\/jats:styled-content> for diagnosis of appendicitis.<\/jats:p><\/jats:sec>Methods<\/jats:title>Records of pediatric emergency department patients aged 3 to 21\u00a0years undergoing MRI<\/jats:styled-content> and\/or US<\/jats:styled-content> for the evaluation of appendicitis were retrospectively reviewed. Radiographs were categorized as a normal appendix, neither demonstrating the appendix nor demonstrating abnormalities consistent with appendicitis; equivocal, not demonstrating the appendix but showing evidence of appendicitis; demonstrating an abnormal appendix consistent with appendicitis; or demonstrating an alternate pathology. The reading was compared with the final diagnosis for accuracy.<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 589 patients included, 146 had appendicitis. Diagnostic accuracy for studies with a nonvisualized appendix without secondary signs of appendicitis was 100% for MRI<\/jats:styled-content> and 91.4% (95% CI<\/jats:styled-content>\u00a0=\u00a087.3% to 94.2%) for US<\/jats:styled-content>. Diagnostic accuracy for studies with a nonvisualized appendix with secondary signs of appendicitis was 50% (95% CI<\/jats:styled-content>\u00a0=\u00a02.5% to 97.5%) for MRI<\/jats:styled-content> and 38.9% (95% CI<\/jats:styled-content>\u00a0=\u00a018.2% to 64.5%) for US<\/jats:styled-content>. Appendicitis was ultimately diagnosed in 8.6% of patients with an otherwise negative right lower quadrant (RLQ<\/jats:styled-content>) US<\/jats:styled-content> that failed to directly identify the appendix. There was a moderate correlation between US<\/jats:styled-content> and MRI<\/jats:styled-content> (\u03c1\u00a0= 0.573, p\u00a0=\u00a00.0001) when all studies were considered.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Magnetic resonance imaging without secondary signs of appendicitis is effective in excluding appendicitis regardless of whether the appendix is directly visualized, while otherwise negative RLQ US<\/jats:styled-content> that fail to identify the appendix are less useful. Secondary signs of appendicitis without visualization of the appendix were not helpful regardless of radiographic modality. Results of MRI<\/jats:styled-content> and US<\/jats:styled-content> correlated moderately well.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.12873","type":"journal-article","created":{"date-parts":[[2016,1,15]],"date-time":"2016-01-15T03:31:02Z","timestamp":1452828662000},"page":"179-185","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Accuracy of Magnetic Resonance Imaging and Ultrasound for Appendicitis in Diagnostic and Nondiagnostic Studies"],"prefix":"10.1111","volume":"23","author":[{"given":"Y. 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