Contrast-enhanced spiral CT evaluation of blunt abdominal trauma

• Published in: JBR-BTR : organe de la Societe royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR) Vol. 88; no. 2; p. 61
• Main Authors: Kailidou, E, Pikoulis, E, Katsiva, V, Karavokyros, I G, Athanassopoulou, A, Papakostantinou, I, Leppaniemi, A, Bramis, I, Tibishrani, M
• Format: Journal Article
• Language: English
• Published: Belgium 01-03-2005
• Subjects: Abdominal Injuries - diagnostic imaging; Adolescent; Adult; Aged; Aged, 80 and over; Contrast Media; False Negative Reactions; Female; Humans; Image Processing, Computer-Assisted - methods; Intestines - diagnostic imaging; Intestines - injuries; Kidney - diagnostic imaging; Kidney - injuries; Liver - diagnostic imaging; Liver - injuries; Male; Mesentery - diagnostic imaging; Mesentery - injuries; Middle Aged; Predictive Value of Tests; Radiographic Image Enhancement - methods; Retrospective Studies; Sensitivity and Specificity; Spleen - diagnostic imaging; Spleen - injuries; Tomography, Spiral Computed - methods; Urinary Bladder - diagnostic imaging; Urinary Bladder - injuries; Wounds, Nonpenetrating - diagnostic imaging
• ISSN: 0302-7430

The purpose of this study was to examine the usefulness and validity of contrast enhanced-spiral computerized tomography in assessing blunt abdominal trauma. 257 patients were admitted in a general hospital over a period of five years and were examined with computed tomography. Two-dimension reconstruction and delayed imaging were used when appropriate. 169 patients underwent a laparotomy, while 88 were treated conservatively. Scans were true positive for intraabdominal damage in 212 patients depicting chiefly splenic, liver, renal, urinary bladder, and mesenteric/intestinal injuries (41%, 18%, 6.6%, 6.6%, and 13.7% respectively). True negative examinations amounted up to 35. 10 non-specific examinations displayed the existence of hemoperitoneum but not the actual damage itself, therefore they were considered false negative. No false positive examination existed. Overall sensitivity was 95%, specificity 100%, positive predictive value 100% and negative predictive value 78%. In conclusion spiral computed tomography is a valuable examination in blunt abdominal trauma as it facilitates diagnosis of intraabdominal damage, assists in defining treatment and occasionally allows foretelling the outcome.