Influence of body habitus and use of oral contrast on reader confidence in patients with suspected acute appendicitis using 64 MDCT

被引:14
作者
Anderson S.W. [1 ]
Rhea J.T. [1 ]
Milch H.N. [1 ]
Ozonoff A. [2 ]
Lucey B.C. [1 ]
Soto J.A. [1 ]
机构
[1] Department of Radiology, Boston University Medical Center, FGH Building, Boston, MA 02218
[2] Department of Biostatistics, Boston University, School of Public Health, Boston, MA 02118
关键词
Appendicitis; Computed tomography; Confidence; Oral contrast;
D O I
10.1007/s10140-010-0875-x
中图分类号
学科分类号
摘要
The purpose of this study is to evaluate how body habitus affects reader confidence in diagnosing acute appendicitis and appendiceal visualization using 64 MDCT technology with and without oral contrast. We conducted a HIPAA compliant, IRB approved study of adult patients presenting to the Emergency Department with nontraumatic abdominal pain. Subjects were randomized to two groups: 64 MDCT scans performed with oral and intravenous contrast or scans performed solely with intravenous contrast. Three radiologists established their confidence about the presence of appendicitis as well as recording whether the appendix was visualized. Reader confidence in diagnosing acute appendicitis was compared between the two groups for the three readers. The impact of patient BMI and estimated intra-abdominal fat on reader confidence in diagnosing appendicitis was determined. Finally, a comparison of the effect of BMI and intra-abdominal fat on appendiceal visualization between the two groups was carried out. Three hundred three patients were enrolled in this study. There was a statistically significant difference in confidence based on BMI for reader 2, group 1 in diagnosing appendicitis. No further statistically significant differences in reader confidence for diagnosing appendicitis based on BMI or intra-abdominal fat were identified. There was no influence of BMI or intra-abdominal fat on appendiceal visualization. Increasing BMI was seen to improve reader confidence for one of three readers in patients that received both oral and intravenous contrast. No further effects of BMI or intra-abdominal fat on confidence in diagnosing or excluding appendicitis were seen. Neither BMI nor intra-abdominal fat were seen to influence appendiceal visualization. © 2010 Am Soc Emergency Radiol.
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页码:445 / 453
页数:8
相关论文
共 21 条
[1]  
Ahn S.H., Mayo-Smith W.W., Murphy B.L., Reinert S.E., Cronan J.J., Acute nontraumatic abdominal pain in adult patients: Abdominal radiography compared with CT evaluation, Radiology, 225, pp. 159-164, (2002)
[2]  
Rosen M.P., Sands D.Z., Longmaid III H.E., Reynolds K.F., Wagner M., Raptopoulos V., Impact of abdominal CT on the management of patients presenting to the emergency department with acute abdominal pain, AJR Am J Roentgenol, 174, pp. 1391-1396, (2000)
[3]  
Marincek B., Nontraumatic abdominal emergencies: Acute abdominal pain: Diagnostic strategies, Eur Radiol, 12, pp. 2136-2150, (2002)
[4]  
Lee S.Y., Coughlin B., Wolfe J.M., Polino J., Blank F.S., Smithline H.A., Prospective comparison of helical CT of the abdomen and pelvis without and with oral contrast in assessing acute abdominal pain in adult Emergency Department patients, Emergency Radiology, 12, 4, pp. 150-157, (2006)
[5]  
Mun S., Ernst R.D., Chen K., Oto A., Shah S., Mileski W.J., Rapid CT diagnosis of acute appendicitis with IV contrast material, Emerg Radiol, 12, pp. 99-102, (2006)
[6]  
Kim H.C., Yang D.M., Jin W., Park S.J., Added diagnostic value of multiplanar reformation of multidetector CT data in patients with suspected appendicitis, Radiographics, 28, pp. 393-405, (2008)
[7]  
Wolfe J.M., Smithline H., Lee S., Coughlin B., Polino J., Blank F., The impact of body mass index on concordance in the interpretation of matched noncontrast and contrast abdominal pelvic computed tomographic scans in ED patients with nontraumatic abdominal pain, American Journal of Emergency Medicine, 24, 2, pp. 144-148, (2006)
[8]  
Zangos S., Steenburg S.D., Phillips K.D., Kerl J.M., Nguyen S.A., Herzog C., Schoepf U.J., Vogl T.J., Costello P., Acute Abdomen. Added Diagnostic Value of Coronal Reformations With 64-Slice Multidetector Row Computed Tomography, Academic Radiology, 14, 1, pp. 19-27, (2007)
[9]  
Anderson S.W., Soto J.A., Et al., Abdominal 64-MDCT for suspected appendicitis: The use of oral and IV contrast material versus IV contrast material only, AJR Am J Roentgenol, 193, 5, pp. 1282-1288, (2009)
[10]  
Miller K.D., Jones E., Yanovski J.A., Shankar R., Feuerstein I., Falloon J., Visceral abdominal-fat accumulation associated with use of indinavir, Lancet, 351, 9106, pp. 871-875, (1998)