APPENDICITIS (last updated 11/13/2020, last reviewed 02/10/2022)
INDICATION: RLQ pain in a pregnant patient. NO IV CONTRAST.
SEQUENCES
Ax HASTE (4mm thickness)
Cor HASTE (4mm thickness)
Sag HASTE (4 mm thickness)
Ax HASTE fat sat (4mm thickness)
Ax VIBE fat-sat
Ax T1 in/out of phase
Cor VIBE fat-sat
Ax 2D TOF
* optional trueFISP imaging
- For pregnant patients with abominal pain
- Noncontrast
- Be sure to image the CECUM in all planes, which is often in a variable position depending on the gestational age.
- Include entire uterus on T1 images (for uterine hemorrhage)
- When possible, images with radiologist
- 2D TOF helps differentiate dilated vessels from the appendix
BREATH HOLDING:
Do not let images "bounce"
Bouncing comes from irreproducible diaphragm positions with multibreathhold acquisitions
SOLUTION:
1) End EXPIRATION breath holds are more reproducble
2) Navigator respiratory triggering
Coronal T2 Cecum
Axial T2 Cecum
Sagittal T2 Cecum
