Document Detail


Nontraumatic acute abdominal pain: unenhanced helical CT compared with three-view acute abdominal series.
MedLine Citation:
PMID:  16183928     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To prospectively evaluate and compare the diagnostic accuracy of unenhanced helical computed tomography (CT) for patients with nontraumatic acute abdominal pain with that of traditional abdominal radiography. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained; this study was completed before implementation of the HIPAA. Ninety-one patients (44 men; 47 women; age range, 18-84 years; mean age, 48.5 years) with acute nontraumatic abdominal pain over a 7-month period were referred by the emergency department of one institution. These patients underwent a three-view acute abdominal series (AAS) and unenhanced helical CT. AAS included an upright chest radiograph and upright and supine abdominal radiographs. Unenhanced helical CT images with 5-mm collimation were obtained from the lung bases to the pubic symphysis, without intravenous, oral, or rectal contrast material. AAS and unenhanced helical CT images were each separately and prospectively interpreted by a different experienced radiologist who was blinded to patient history and the images and interpretation of the other examination for each patient. Final diagnosis was established with surgical, pathologic, and clinical follow-up. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and positive and negative likelihood ratios were calculated for AAS and unenhanced helical CT. Confidence intervals of 95% were calculated for each value with the standard equation for population proportions. Results of AAS and unenhanced helical CT examinations were compared with chi2 analysis. RESULTS: Among the 91 patients examined, unenhanced helical CT yielded an overall sensitivity, specificity, and accuracy of 96.0%, 95.1%, and 95.6%, respectively. The AAS interpretations yielded an overall sensitivity, specificity, and accuracy of 30.0%, 87.8%, and 56.0%, respectively. The accuracy of unenhanced helical CT was significantly greater than the accuracy of AAS (P < .05). CONCLUSION: AAS is an insensitive technique in the evaluation of nontraumatic acute abdominal pain in adults. Unenhanced helical CT is an accurate technique in the evaluation of adult patients with nontraumatic acute abdominal pain and should be considered as an alternative to radiography as the initial imaging modality.
Authors:
Andrew B MacKersie; Michael J Lane; Robert T Gerhardt; Harry A Claypool; Sean Keenan; Douglas S Katz; Jonathan E Tucker
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Radiology     Volume:  237     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-26     Completed Date:  2005-10-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  114-22     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Wilford Hall Medical Center, Lackland Air Force Base, Tex, USA. amackersie@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Abdomen, Acute / radiography*
Adolescent
Adult
Aged
Aged, 80 and over
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Probability
Prospective Studies
Sensitivity and Specificity
Tomography, Spiral Computed* / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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