Effectiveness of computed tomography scanning to detect blunt bowel and mesenteric injuries requiring surgical intervention: A systematic literature review - 14/06/19
, C. Michael Dunham b Abstract |
Background |
Computed tomography (CT) diagnostic accuracy for blunt bowel and mesenteric injuries (BBMI) is controversial.
Data sources |
A literature review to compute aggregate CT performance and individual CT sign sensitivity, specificity, and positive predictive value (PPV) for operative BBMI.
Conclusions |
Sensitivity, specificity, and PPV were: overall CT performance 85.3%, 96.1%, 51.4%; abnormal wall enhancement 30.1%, 95.7%, 64.0%; bowel wall discontinuity 22.3%, 99.0%, 87.9%; bowel wall hematoma 22.5%, 100%, 19.5%; bowel wall thickening 35.2%, 96.5%, 32.1%; free air 32.0%, 98.7%, 57.1%; free fluid 65.6%, 85.0%, 25.5%; mesenteric air 27.6%, 99.1%, 85.3%; mesenteric extravasation 22.9%, 99.6%, 73.9%; mesenteric hematoma/fluid 33.9%, 98.7%, 52.8%; mesenteric stranding/streaking 34.3%, 91.8%, 31.6%; mesenteric vessel beading 32.1%, 97.2%, 60.4%; mesenteric vessel termination 31.6%, 97.2%, 63.5%; oral contrast extravasation 10.0%, 100%, 100%; retroperitoneal air 9.4%, 94.9%, 55.6%; and retroperitoneal fluid 44.2%, 49.4%, 38.5%. Sensitivity, specificity, and PPV vary substantially among known signs. Other clinical factors are necessary for comprehensive BBMI identification.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Overall CT performance had sensitivity 85.3%, specificity 96.1%, and PPV 51.4%. |
• | Sensitivity for individual CT signs ranged from 9.4% to 65.6%. |
• | Specificity for individual CT signs ranged from 49.4% to 100%. |
• | Positive predictive value for individual CT signs ranged from 19.5% to 100%. |
• | Comprehensive identification of BBMI requires other clinical factors than CT alone. |
Keywords : Mesenteric injury, Hollow viscus injury, Abdominal computed tomography, Computed tomography performance, Diagnostic accuracy
Plan
Vol 218 - N° 1
P. 201-210 - juillet 2019 Retour au numéro
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