Ces radiol. 2021, 75(1):102-105 | DOI: 10.55095/CesRadiol2021/013
The role of CT in diagnosing acute abdomen following negative ultrasound examination - a retrospective studyOriginal article
- Klinika radiologie a nukleární medicíny FN Brno a LF MU
Aim: To evaluate the correlation of CT scan with ultrasound findings in patients who clinically presented with acute abdomen and their ultrasound examination did not show any explanatory pathology.
Method: We evaluated a cohort of 129 consecutive patients (19-91 years, men 59, women 70) who had abdominal CT scan performed in line with the local guidelines in the University Hospital Brno in June 2017 to May 2018. The percentage of CT scans with significant pathology and negative predictive value for abdominal ultrasound were calculated. The diagnoses identified on CT were reviewed and further divided in groups with calculation of the overall number of cases in each group.
Results: Out of 129 cases, CT scan confirmed acute abdomen in 50 cases (39%). In 6 cases (5%), CT scan showed non-specific features only. The negative predictive value for abdominal ultrasound examination was 0.57. CT diagnoses : acute pancreatitis 9, diverticulitis 9, appendicitis 9, ileus 6, cholecystitis 4, colitis 2, nephritis 2. In 20 patients the ultrasound examination was suboptimal due to obesity (in 7 cases CT revealed the diagnosis).
Conclusion: CT scan following a negative abdominal ultrasound examination revealed the underlying diagnosis in less than half of the cases. The negative predictive value of ultrasound is relatively low. Therefore, a negative ultrasound scan does not rule out a significant abdominal pathology. This can be due to a number of diagnoses which are difficult to identify in patients with obesity or anatomical abnormalities.
Keywords: acute abdomen, CT, ultrasound
Grants and funding:
Podpořeno MZ ČR - RVO (FNBr, 65269705).
Supported by Ministry of Health, Czech Republic - conceptual development of research organization (FNBr, 65269705).
Accepted: March 25, 2021; Published: March 1, 2021 Show citation
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