Of the 19 included patients, 9 patients underwent pelvic MRI without and with IV contrast. Of these, 88% (8/9) of the patients were found to have a focal collection compatible with a perianal abscess. This resulted in intraoperative drainage of the fluid collection in 6 patients, of whom 80% (5/6) of patients were confirmed to have a purulent draining cavity intraoperatively; 20% (1/6) of the patients was deemed to be a false-positive result. MRI Abdomen and Pelvis Without IV Contrast There are no data to support the use of MRI abdomen and pelvis without IV contrast as an initial diagnostic imaging study in the diagnosis of sepsis. Nuclear Medicine Scan Gallbladder There are no data to support the use of nuclear medicine scan gallbladder as an initial diagnostic imaging study in the diagnosis of sepsis. Radiography Abdomen Although abdominal radiography is portable and rapidly acquired, it rarely provides a definitive diagnosis in the setting of sepsis. It may provide information that increases the probability of an abdominal source such as pneumoperitoneum, but these findings would likely be suspected by physical examination and necessitate further evaluation with CT or US regardless [15,16]. US Abdomen Abdominal/pelvic US is often chosen as the initial imaging modality in patients of child-bearing age in the evaluation of suspected intraabdominal sepsis. Potential diagnoses responsible for sepsis in this setting can be divided into gynecological causes (such as endometritis, salpingitis, oophoritis, tubo-ovarian abscess, pelvic peritonitis) and nongynecological causes (such as acute appendicitis, diverticulitis, ileitis/colitis, epiploic appendagitis, and urological causes), which can be assessed to varying degrees on US [17]. In the setting of urosepsis, US is often considered the first imaging modality of choice in part because of its portability and rapid acquisition [15,16].
Sepsis. Of the 19 included patients, 9 patients underwent pelvic MRI without and with IV contrast. Of these, 88% (8/9) of the patients were found to have a focal collection compatible with a perianal abscess. This resulted in intraoperative drainage of the fluid collection in 6 patients, of whom 80% (5/6) of patients were confirmed to have a purulent draining cavity intraoperatively; 20% (1/6) of the patients was deemed to be a false-positive result. MRI Abdomen and Pelvis Without IV Contrast There are no data to support the use of MRI abdomen and pelvis without IV contrast as an initial diagnostic imaging study in the diagnosis of sepsis. Nuclear Medicine Scan Gallbladder There are no data to support the use of nuclear medicine scan gallbladder as an initial diagnostic imaging study in the diagnosis of sepsis. Radiography Abdomen Although abdominal radiography is portable and rapidly acquired, it rarely provides a definitive diagnosis in the setting of sepsis. It may provide information that increases the probability of an abdominal source such as pneumoperitoneum, but these findings would likely be suspected by physical examination and necessitate further evaluation with CT or US regardless [15,16]. US Abdomen Abdominal/pelvic US is often chosen as the initial imaging modality in patients of child-bearing age in the evaluation of suspected intraabdominal sepsis. Potential diagnoses responsible for sepsis in this setting can be divided into gynecological causes (such as endometritis, salpingitis, oophoritis, tubo-ovarian abscess, pelvic peritonitis) and nongynecological causes (such as acute appendicitis, diverticulitis, ileitis/colitis, epiploic appendagitis, and urological causes), which can be assessed to varying degrees on US [17]. In the setting of urosepsis, US is often considered the first imaging modality of choice in part because of its portability and rapid acquisition [15,16].