TUFAN EGELİ, CİHAN AĞALAR, ZEKAİ SERHAN DERİCİ, Süleyman Özkan AKSOY, TAYFUN BİŞGİN, ALİ DURUBEY ÇEVLİK, MÜCAHİT ÖZBİLGİN, BAŞAK BAYRAM, Erkan ÇAĞLIYAN, IŞIL BAŞARA AKIN, CANAN ALTAY, MUSTAFA SEÇİL

GEBELİKTE AKUT APANDİSİTİ BELİRLEMEDE MANYETİK REZONANS GÖRÜNTÜLEMENİN ROLÜ

Giriş: Çalışmanın amacı akut apandisit şüphesi olan gebe hastalarda manyetik rezonans görüntüleme(MRG)’nin tanı koymada etkinliğinin değerlendirilmesidir. Gereç ve Yöntem: Çalışmaya 1 Ocak 2008 – 1 Ocak 2018 tarihleri arasında Dokuz Eylül Üniversitesi Tıp Fakültesi Acil Servisi’ne akut karın ağrısı ile başvuran ve akut apandisit şüphesi ile MRG görüntüleme yapılan, 18- 50 yaş arası gebe hastalar alındı. Hastalara ait veriler retrospektif olarak toplandı. Manyetik rezonans görüntülemenin gebelikte akut apandisit tanısal sensitivitesi, spesifitesi ve güvenilirliği analiz edildi. Bulgular: Çalışmaya toplam 33 hasta alındı. Preoperatif MRG yapılan olguların 6(%18)’sında akut apandisit, 1(%0.3)’inde ise sağ over torsiyonu saptandı. Preoperatif bu tanıların doğruluğu, intraoperatif bulgular ve patolojik incelemeler ile kanıtlandı. Diğer 26(%78) hastada MRG akut apandisit ya da başka bir abdominal cerrahi patoloji belirlemedi. Bu hastalardan birisinde klinik şüphe duyulması nedeniyle apendektomi yapıldı ancak patolojik bulgular akut apandisit olarak yorumlanmadı. Geriye kalan 25(%75.7) hasta opere edilmedi ve takipte hiçbirisinde cerrahi patoloji gelişmedi. Hastaların hiçbirinde MRG ilişkili maternal ya da fetal komplikasyon gelişmedi. Çalışmamızda MRG’nin gebelikte akut apandisiti saptamada sensitivite ve spesifitesi %100 olarak belirlendi. Sonuç: Manyetik rezonans görüntüleme, gebelik döneminde akut apandisit tanısını yüksek sensitivite ve spesifite ile koymayı sağlayan güvenlir bir yöntemdir.

THE ROLE OF MAGNETIC RESONANCE IMAGING TO DETERMINE ACUTE APPENDICITIS DURING PREGNANCY

Introduction: The aim of this study is to evaluate the performance of magnetic resonance imaging(MRI) for acute appendicitis during pregnancy. Material and Method: The study included pregnant women aged between 18 and 50 years who were admitted to the Emergency Department of Dokuz Eylul University Medical Faculty between January 1, 2008 and January 1, 2018 with acute abdominal pain and suspected acute appendicitis and had MRI. Data were collected retrospectively. Diagnostic sensitivity, specificity and reliability of magnetic resonance imaging during pregnancy were analyzed. Results: A total of 33 patients were included in the study. Six (18%) acute appendicitis and 1(0.3%) right ovarian torsion were detected in preoperative MRI. The accuracy of these diagnoses was demonstrated by intraoperative findings and pathological examinations. In 26 (78%) other patients, MRI did not detect acute appendicitis or another abdominal surgical pathology. Appendectomy was performed in one of these patients because of clinical suspicion, and pathological findings were not interpreted as acute appendicitis. None of the remaining 25(75.7%) patients developed surgical abdominal pathology. None of the patients had maternal or fetal complications associated with MRI. In our study, the sensitivity and specificity of MRI in detecting acute appendicitis during pregnancy was 100%. Conclusion: Magnetic resonance imaging is a safe method of detecting acute appendicitis during pregnancy with high sensitivity and specificity.

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