| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
1 All authors: Department of Radiology, University of Pittsburgh Medical Center-Presbyterian Hospital, 200 Lothrop St., Pittsburgh, PA 15213.
OBJECTIVE. The objective of our study was to identify relevant and reliable CT signs of bowel injury, to determine the overall performance of CT in detection of bowel injuries, and to establish the effect of the training level of radiologists on this performance.
MATERIALS AND METHODS. Abdominal CT scans of 112 patients with blunt abdominal trauma were prospectively and retrospectively reviewed. Fifty patients had proven bowel injuries (with or without other visceral injuries), whereas 62 patients had no bowel injury and comprised the comparison or control group. Thirty-one of the 62 patients in the comparison group had surgical proof of abdominal but not bowel or mesenteric injuries. The retrospective review of the 112 CT scans was performed randomly and individually by nine radiologists unaware of the diagnosis, including three faculty abdominal radiologists, three senior residents in training, and three junior residents in training. Individual performance and group performance were evaluated by receiver operating characteristic analysis, and interobserver agreement was tested. Individual CT signs as relevant predictors of bowel injury were identified by logistic regression.
RESULTS. Relevant predictors of bowel injury included mesenteric infiltration, bowel wall thickening, extravasation of vascular or enteric contrast agent, and the presence free air. In the retrospective blinded review, CT showed good to excellent interobserver reliability for individual CT signs as well as for diagnosis of bowel and visceral injuries. Faculty radiologists tended to diagnose injuries with greater accuracy and confidence, but they showed significantly better performance than residents only in diagnosing duodenal perforation. For the prospective CT diagnosis of bowel injury, CT had a sensitivity of 64%, an accuracy of 82%, and a specificity of 97%.
CONCLUSION. Bowel injuries are challenging to diagnose on CT. Radiologists with various levels of experience and expertise can achieve accurate and reproducible results using a variety of CT criteria.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
|
|
 |
|
  R ZISSIN, A OSADCHY, and G GAYER Abdominal CT findings in small bowel perforation Br. J. Radiol., February 1, 2009; 82(974): 162 - 171. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Atri, J. M. Hanson, L. Grinblat, N. Brofman, T. Chughtai, and G. Tomlinson Surgically Important Bowel and/or Mesenteric Injury in Blunt Trauma: Accuracy of Multidetector CT for Evaluation Radiology, November 1, 2008; 249(2): 524 - 533. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Whitfield and J. Garner Beyond splenectomy -- options for the management of splenic trauma Trauma, October 1, 2008; 10(4): 247 - 259. [Abstract] [PDF]
|
|
|
|
|
|
C. Whitfield and J.P. Garner The early management of gunshot wounds Part II: the abdomen, extremities and special situations Trauma, January 1, 2007; 9(1): 47 - 71. [Abstract] [PDF]
|
|
|
|
|
|
J. W. Stuhlfaut, J. A. Soto, B. C. Lucey, A. Ulrich, N. K. Rathlev, P. A. Burke, and E. F. Hirsch Blunt Abdominal Trauma: Performance of CT without Oral Contrast Material Radiology, December 1, 2004; 233(3): 689 - 694. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Shanmuganathan, S. E. Mirvis, W. C. Chiu, K. L. Killeen, G. J. F. Hogan, and T. M. Scalea Penetrating Torso Trauma: Triple-Contrast Helical CT in Peritoneal Violation and Organ Injury--A Prospective Study in 200 Patients Radiology, June 1, 2004; 231(3): 775 - 784. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. B. Sirlin, M. A. Brown, O. A. Andrade-Barreto, R. Deutsch, D. A. Fortlage, D. B. Hoyt, and G. Casola Blunt Abdominal Trauma: Clinical Value of Negative Screening US Scans Radiology, March 1, 2004; 230(3): 661 - 668. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Wittenberg, M. G. Harisinghani, K. Jhaveri, J. Varghese, and P. R. Mueller Algorithmic Approach to CT Diagnosis of the Abnormal Bowel Wall RadioGraphics, September 1, 2002; 22(5): 1093 - 1107. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Shanmuganathan, S. E. Mirvis, W. C. Chiu, K. L. Killeen, and T. M. Scalea Triple-Contrast Helical CT in Penetrating Torso Trauma: A Prospective Study to Determine Peritoneal Violation and the Need for Laparotomy Am. J. Roentgenol., December 1, 2001; 177(6): 1247 - 1256. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
