European journal of radiology · 2025
Rapid MR examination with deep learning reconstruction improves diagnosis of complicated acute appendicitis.
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Liu Jing-Juan, Lin Chen, Liu Wei, Zhu Liang, Ma Chen-Xue, Wang Xuan, Xu Jia, Lu Yi-Tong, Zhang Yi-Fei, Jiang Bo, Wang Wei-Bin, Feng Feng
Аннотация
OBJECTIVE: To evaluate the performance of a non-contrast rapid magnetic resonance imaging (MRI) protocol with deep learning reconstruction (DLR) for identifying complicated appendicitis in patients with acute appendicitis, compared to conventional MRI without DLR (non-DLR) and non-contrast computed tomography (NC-CT).
METHODS: Sixty-two eligible patients were enrolled, of which 55 had a final diagnosis of acute appendicitis and were included for further analysis of complications. Among them, 51 underwent both NC-CT and MRI, while 4 pregnant patients underwent MRI only. The MRI protocol included T2-weighted imaging (with and without fat suppression), T1-weighted imaging, and diffusion-weighted imaging (DWI). Two abdominal radiologists independently evaluated the subjective and objective image quality of DLR and non-DLR images using a 5-point Likert scale to assess diagnostic confidence for complicated appendicitis. Interobserver agreement (kappa statistics) and receiver operating characteristic (ROC) analysis were performed.
RESULTS: MRI with DLR demonstrated significantly better objective and subjective image quality than non-DLR MRI, with improved appendix delineation and reduced noise (p < 0.01). With a mean acquisition time of 9.5 min, both MRI protocols outperformed NC-CT in the diagnosis of complicated appendicitis (p = 0.035 andp = 0.001, respectively). MRI-DLR achieved higher sensitivity (97.06 % vs. 88.24 %) and negative predictive value (95.45 % vs. 84.00 %) for complicated appendicitis than MRI-non-DLR. The detection rates of appendiceal wall discontinuity and peri-appendiceal abscesses were significantly higher with MRI-DLR (p < 0.05).
CONCLUSION: Rapid MRI with DLR improves image quality and diagnostic accuracy for complicated appendicitis compared to non-DLR MRI and NC-CT, offering a valuable alternative for radiation-sensitive patients.
METHODS: Sixty-two eligible patients were enrolled, of which 55 had a final diagnosis of acute appendicitis and were included for further analysis of complications. Among them, 51 underwent both NC-CT and MRI, while 4 pregnant patients underwent MRI only. The MRI protocol included T2-weighted imaging (with and without fat suppression), T1-weighted imaging, and diffusion-weighted imaging (DWI). Two abdominal radiologists independently evaluated the subjective and objective image quality of DLR and non-DLR images using a 5-point Likert scale to assess diagnostic confidence for complicated appendicitis. Interobserver agreement (kappa statistics) and receiver operating characteristic (ROC) analysis were performed.
RESULTS: MRI with DLR demonstrated significantly better objective and subjective image quality than non-DLR MRI, with improved appendix delineation and reduced noise (p < 0.01). With a mean acquisition time of 9.5 min, both MRI protocols outperformed NC-CT in the diagnosis of complicated appendicitis (p = 0.035 andp = 0.001, respectively). MRI-DLR achieved higher sensitivity (97.06 % vs. 88.24 %) and negative predictive value (95.45 % vs. 84.00 %) for complicated appendicitis than MRI-non-DLR. The detection rates of appendiceal wall discontinuity and peri-appendiceal abscesses were significantly higher with MRI-DLR (p < 0.05).
CONCLUSION: Rapid MRI with DLR improves image quality and diagnostic accuracy for complicated appendicitis compared to non-DLR MRI and NC-CT, offering a valuable alternative for radiation-sensitive patients.