MRI for Clinically Suspected Appendicitis During Pregnancy
Lodewijk P. Cobben1,
Ingrid Groot2,
Lucien Haans3,
Johan G. Blickman4 and
Julien Puylaert1
1 Department of Radiology, Medisch Centrum Haaglanden, Burgemeester Banninglaan
1, Leidschendam 2582HS, The Netherlands.
2 Department of Surgery, Medisch Centrum Haaglanden, Leidschendam 2582HS, The
Netherlands.
3 Department of Obstetrics and Gynecology, Medisch Centrum Haaglanden,
Leidschendam 2582HS, The Netherlands.
4 Department of Radiology, University Medical Centre Nijmegen, 6500 HB Nijmegen,
The Netherlands.

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Fig. 1. 26-year-old woman in 11th week of pregnancy with right lower
quadrant pain and clinical suspicion of appendicitis. Coronal T2-weighted
image shows inflamed appendix (arrow). At base of appendix, rounded
intraluminal structure without signal intensity (white arrowhead) is
seen, representing appendicolith, which was confirmed by surgery and
pathology. Fetus (black arrowheads) is clearly visible.
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Fig. 2A. 33-year-old woman in 13th week of pregnancy with 2 days of right
lower quadrant pain and clinical suspicion of appendicitis. Coronal (A)
and axial (B) T2-weighted images show enlarged appendix (white
arrow) surrounded by hyperintense mass of inflamed fat
(arrowheads). Enlarged uterus (black arrow, A) is
also seen.
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Fig. 2B. 33-year-old woman in 13th week of pregnancy with 2 days of right
lower quadrant pain and clinical suspicion of appendicitis. Coronal (A)
and axial (B) T2-weighted images show enlarged appendix (white
arrow) surrounded by hyperintense mass of inflamed fat
(arrowheads). Enlarged uterus (black arrow, A) is
also seen.
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Fig. 2C. 33-year-old woman in 13th week of pregnancy with 2 days of right
lower quadrant pain and clinical suspicion of appendicitis. T2-weighted
coronal fat-suppressed image clearly shows inflammatory changes around
appendix (arrowheads) as areas with high signal intensity. Enlarged
uterus (arrow) is also seen. Appendix itself is not clearly visible
in this image.
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Fig. 2D. 33-year-old woman in 13th week of pregnancy with 2 days of right
lower quadrant pain and clinical suspicion of appendicitis. Axial T1-weighted
image shows inflammatory changes around appendix as low-signal-intensity mass
(arrowheads). Appendix itself could not be depicted in this mass.
Appendectomy was performed and nonperforated gangrenous appendix was removed.
Enlarged uterus (arrow) is also seen.
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Fig. 3A. 30-year-old woman in 16th week of pregnancy with clinically
suspected appendicitis. Axial T2-weighted image shows enlarged appendix
(arrow); appendix is in retrocecal position.
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Fig. 3B. 30-year-old woman in 16th week of pregnancy with clinically
suspected appendicitis. Axial T1-weighted image shows inflamed appendix
(arrow) with some hypointense fat-stranding in surrounding fat.
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Fig. 3C. 30-year-old woman in 16th week of pregnancy with clinically
suspected appendicitis. Coronal T2-weighted image shows part of inflamed
appendix (white arrow) and enlarged uterus (black
arrow).
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Fig. 4. 32-year-old woman in 17th week of pregnancy with right lower
quadrant pain and clinically suspected appendicitis. Coronal T2-weighted image
shows retrocecal normal-sized appendix (arrow) without inflammatory
changes. Gravid uterus (arrowhead) is visible as well.
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Copyright © 2004 by the American Roentgen Ray Society.