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Tomoelastography for non-invasive detection and treatment monitoring in acute appendicitis
  1. Stephan Rodrigo Marticorena Garcia,
  2. Bernd Hamm and
  3. Ingolf Sack
  1. Radiology, Charité Universitätsmedizin Berlin, Berlin, Germany
  1. Correspondence to Dr Stephan Rodrigo Marticorena Garcia, stephan.marticorena-garcia{at}


Acute appendicitis is the most common cause of the acute abdomen syndrome and can be treated either surgically or conservatively with antibiotics. This case demonstrates the first time use of mechanics based MRI by tomoelastography with generation of quantitative maps of tissue stiffness (shear wave speed in m/s) and tissue fluidity (shear modulus loss angle, in rad) in a case of uncomplicated acute appendicitis with antibiotic treatment at (i) baseline, (ii) the end of treatment (EOT) and (iii) the 10 day follow-up after EOT. Baseline maps of stiffness and fluidity revealed to the naked eye the extent of intestinal inflammation by markedly increased values of stiffness and fluidity (2.56±0.12 m/s, 1.37±0.24 rad) compared with normal values, indicating the immediate response to antibiotic treatment at EOT (1.47±0.28 m/s, 0.80±0.11 rad) and persistent normalisation at follow-up (1.54±0.22 m/s, 0.92±0.22 rad). Tomoelastography is a non-invasive, quantitative imaging method for mechanics based characterisation and follow-up of acute appendicitis.

  • radiology
  • infection (gastroenterology)
  • drugs: gastrointestinal system
  • drug therapy related to surgery
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  • Contributors SRMG and IS: conception, design, and analysis and interpretation of the data. SRMG: drafting the article. SRMG, BH and IS: revising the manuscript critically for important intellectual content and final approval of the version published.

  • Funding This study was funded by Bundesministerium für Bildung und Forschung (grant No: LiSyM 031L0057) and Deutsche Forschungsgemeinschaft (grant No: BIOQIC GRK 2260, SFB 1340).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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