RESUMO
PURPOSE: The purpose of this study was to evaluate the diagnostic accuracy of full-body linear X-ray scanning (LS) in multiple trauma patients in comparison to 128-multislice computed tomography (MSCT). MATERIALS AND METHODS: 106 multiple trauma patients (female: 33; male: 73) were retrospectively included in this study. All patients underwent LS of the whole body, including extremities, and MSCT covering the neck, thorax, abdomen, and pelvis. The diagnostic accuracy of LS for the detection of fractures of the truncal skeleton and pneumothoraces was evaluated in comparison to MSCT by two observers in consensus. Extremity fractures detected by LS were documented. RESULTS: The overall sensitivity of LS was 49.2â%, the specificity was 93.3â%, the positive predictive value was 91â%, and the negative predictive value was 57.5â%. The overall sensitivity for vertebral fractures was 16.7â%, and the specificity was 100â%. The sensitivity was 48.7â% and the specificity 98.2â% for all other fractures. Pneumothoraces were detected in 12 patients by CT, but not by LS.â40 extremity fractures were detected by LS, of which 4 fractures were dislocated, and 2 were fully covered by MSCT. CONCLUSION: The diagnostic accuracy of LS is limited in the evaluation of acute trauma of the truncal skeleton. LS allows fast whole-body X-ray imaging, and may be valuable for detecting extremity fractures in trauma patients in addition to MSCT. KEY POINTS: âThe overall sensitivity of LS for truncal skeleton injuries in multiple-trauma patients was <â50â%. The diagnostic reference standard MSCT is the preferred and reliable imaging modality. LS may be valuable for quick detection of extremity fractures.
Assuntos
Tomografia Computadorizada Multidetectores/métodos , Traumatismo Múltiplo/diagnóstico por imagem , Imagem Corporal Total/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Sensibilidade e Especificidade , Adulto JovemAssuntos
Angiomiolipoma/diagnóstico , Cisto Broncogênico/diagnóstico , Neoplasias Renais/diagnóstico , Neoplasias Pulmonares/diagnóstico , Linfangiomioma/diagnóstico , Adulto , Angiomiolipoma/complicações , Angiomiolipoma/terapia , Cisto Broncogênico/complicações , Cisto Broncogênico/terapia , Terapia Combinada , Drenagem , Dispneia/diagnóstico , Dispneia/etiologia , Dispneia/prevenção & controle , Feminino , Humanos , Neoplasias Renais/complicações , Neoplasias Renais/terapia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/terapia , Linfangiomioma/complicações , Linfangiomioma/terapia , Pneumonectomia , Pneumotórax , Resultado do TratamentoAssuntos
Complicações do Trabalho de Parto/diagnóstico , Complicações do Trabalho de Parto/terapia , Stents , Trombectomia , Tomografia Computadorizada por Raios X , Ultrassonografia , Trombose Venosa/diagnóstico , Trombose Venosa/terapia , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Gravidez , Resultado do TratamentoRESUMO
A 68-year-old male patient presented with mild tenderness in the suprasymphyseal region, hematuria and dysuria. In this case typical symptoms of a sigmoid-vesical fistula were initially absent. Because of hematuria and the findings provided by urethrocystoscopy, the radiological diagnosis was a bladder tumor. Contrast-enhanced computed tomography with rectal contrast administration provided the decisive information. In addition to sigmoid diverticulitis (fat stranding/centipede sign) in the urographic phase, contrast media was well traceable intraluminally from the bladder through the bladder wall abscess and subsequently in the sigmoid colon.
