Diagnostic performance of ultra-low dose versus standard dose CT for non-traumatic abdominal emergencies.
Diagn Interv Imaging
; 102(6): 379-387, 2021 Jun.
Article
em En
| MEDLINE
| ID: mdl-33714689
ABSTRACT
PURPOSE:
The purpose of this study was to compare the diagnostic performance of ultra-low dose (ULD) to that of standard (STD) computed tomography (CT) for the diagnosis of non-traumatic abdominal emergencies using clinical follow-up as reference standard. MATERIALS ANDMETHODS:
All consecutive patients requiring emergency abdomen-pelvic CT examination from March 2017 to September 2017 were prospectively included. ULD and STD CTs were acquired after intravenous administration iodinated contrast medium (portal phase). CT acquisitions were performed at 125mAs for STD and 55mAs for ULD. Diagnostic performance was retrospectively evaluated on ULD and STD CTs using clinical follow-up as a reference diagnosis.RESULTS:
A total of 308 CT examinations from 308 patients (145 men; mean age 59.1±20.7 (SD) years; age range 18-96 years) were included; among which 241/308 (78.2%) showed abnormal findings. The effective dose was significantly lower with the ULD protocol (1.55±1.03 [SD] mSv) than with the STD (3.67±2.56 [SD] mSv) (P<0.001). Sensitivity was significantly lower for the ULD protocol (85.5% [95%CI 80.4-89.4]) than for the STD (93.4% [95%CI 89.4-95.9], P<0.001) whereas specificities were similar (94.0% [95%CI 85.1-98.0] vs. 95.5% [95%CI 87.0-98.9], respectively). ULD sensitivity was equivalent to STD for bowel obstruction and colitis/diverticulitis (96.4% [95%CI 87.0-99.6] and 86.5% [95%CI 74.3-93.5] for ULD vs. 96.4% [95%CI 87.0-99.6] and 88.5% [95%CI 76.5-94.9] for STD, respectively) but lower for appendicitis, pyelonephritis, abscesses and renal colic (75.0% [95%CI 57.6-86.9]; 77.3% [95%CI 56.0-90.1]; 90.5% [95%CI 69.6-98.4] and 85% [95%CI 62.9-95.4] for ULD vs. 93.8% [95%CI 78.6-99.2]; 95.5% [95%CI 76.2-100.0]; 100.0% [95%CI 81.4-100.0] and 100.0% [95%CI 80.6-100.0] for STD, respectively). Sensitivities were significantly different between the two protocols only for appendicitis (P=0.041).CONCLUSION:
In an emergency context, for patients with non-traumatic abdominal emergencies, ULD-CT showed inferior diagnostic performance compared to STD-CT for most abdominal conditions except for bowel obstruction and colitis/diverticulitis detection.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tomografia Computadorizada por Raios X
/
Emergências
Tipo de estudo:
Diagnostic_studies
/
Guideline
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Observational_studies
Limite:
Adolescent
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Adult
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Aged
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Aged80
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Diagn Interv Imaging
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
França