Abstract
BACKGROUND: We examined patients of blunt trauma with contrast-enhanced multiphasic computed tomography (CT) and determined if it could detect pancreatic duct injuries. METHODS: During a 17-month period, 95 patients of blunt abdominal trauma underwent multiphasic CT examinations. The CT grading scales of pancreatic injuries at parenchymal phase, portal venous phase, and equilibrium phase were recorded and compared with surgery, endoscopic retrograde cholangiopancreatography, or discharged diagnosis. The diagnostic values of multiphasic CT and interobserver agreements at different phases were computed. RESULTS: Of the 95 patients, nine (9.5%) had pancreatic injuries (six with main duct injuries, three without main duct injuries). The interobserver agreement presented in kappa values between two radiologists regarding the integrity or disruption of the main duct were good at parenchymal phase (K = 0.73), portal venous phase (K = 0.64), and equilibrium phase (K = 0.68). The overall accuracies of multiphasic CT in detecting main duct injuries were 97.9% (parenchymal phase), 100.0% (portal venous phase), and 96.8% (equilibrium phase), respectively. The sensitivity (50.0%) and negative predictive value (96.7%) of equilibrium phase CT were the lowest among the three phases of CT scans. CONCLUSION: The portal venous phase CT was the most accurate scan to detect pancreatic duct injuries. However, equilibrium phase CT might underestimate major pancreatic injuries. Multiphasic CT shows early promise in this clinical application and further multi-institutional studies to verify its accuracy and reveal the optimal CT methodology are needed.
| Original language | English |
|---|---|
| Pages (from-to) | 666-672 |
| Number of pages | 7 |
| Journal | Journal of Trauma - Injury, Infection and Critical Care |
| Volume | 64 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 2008 |
| Externally published | Yes |
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Keywords
- Blunt abdominal injuries
- Multidetector CT
- Multiphasic CT
- Pancreatic duct injuries
ASJC Scopus subject areas
- Surgery
Cite this
Multidetector-row computed tomography (CT) of blunt pancreatic injuries : Can contrast-enhanced multiphasic CT detect pancreatic duct injuries? / Wong, Yon Cheong; Wang, Li Jen; Fang, Jen Feng; Lin, Being Chuan; Ng, Chip Jin; Chen, Ray Jade.
In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 64, No. 3, 03.2008, p. 666-672.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Multidetector-row computed tomography (CT) of blunt pancreatic injuries
T2 - Can contrast-enhanced multiphasic CT detect pancreatic duct injuries?
AU - Wong, Yon Cheong
AU - Wang, Li Jen
AU - Fang, Jen Feng
AU - Lin, Being Chuan
AU - Ng, Chip Jin
AU - Chen, Ray Jade
PY - 2008/3
Y1 - 2008/3
N2 - BACKGROUND: We examined patients of blunt trauma with contrast-enhanced multiphasic computed tomography (CT) and determined if it could detect pancreatic duct injuries. METHODS: During a 17-month period, 95 patients of blunt abdominal trauma underwent multiphasic CT examinations. The CT grading scales of pancreatic injuries at parenchymal phase, portal venous phase, and equilibrium phase were recorded and compared with surgery, endoscopic retrograde cholangiopancreatography, or discharged diagnosis. The diagnostic values of multiphasic CT and interobserver agreements at different phases were computed. RESULTS: Of the 95 patients, nine (9.5%) had pancreatic injuries (six with main duct injuries, three without main duct injuries). The interobserver agreement presented in kappa values between two radiologists regarding the integrity or disruption of the main duct were good at parenchymal phase (K = 0.73), portal venous phase (K = 0.64), and equilibrium phase (K = 0.68). The overall accuracies of multiphasic CT in detecting main duct injuries were 97.9% (parenchymal phase), 100.0% (portal venous phase), and 96.8% (equilibrium phase), respectively. The sensitivity (50.0%) and negative predictive value (96.7%) of equilibrium phase CT were the lowest among the three phases of CT scans. CONCLUSION: The portal venous phase CT was the most accurate scan to detect pancreatic duct injuries. However, equilibrium phase CT might underestimate major pancreatic injuries. Multiphasic CT shows early promise in this clinical application and further multi-institutional studies to verify its accuracy and reveal the optimal CT methodology are needed.
AB - BACKGROUND: We examined patients of blunt trauma with contrast-enhanced multiphasic computed tomography (CT) and determined if it could detect pancreatic duct injuries. METHODS: During a 17-month period, 95 patients of blunt abdominal trauma underwent multiphasic CT examinations. The CT grading scales of pancreatic injuries at parenchymal phase, portal venous phase, and equilibrium phase were recorded and compared with surgery, endoscopic retrograde cholangiopancreatography, or discharged diagnosis. The diagnostic values of multiphasic CT and interobserver agreements at different phases were computed. RESULTS: Of the 95 patients, nine (9.5%) had pancreatic injuries (six with main duct injuries, three without main duct injuries). The interobserver agreement presented in kappa values between two radiologists regarding the integrity or disruption of the main duct were good at parenchymal phase (K = 0.73), portal venous phase (K = 0.64), and equilibrium phase (K = 0.68). The overall accuracies of multiphasic CT in detecting main duct injuries were 97.9% (parenchymal phase), 100.0% (portal venous phase), and 96.8% (equilibrium phase), respectively. The sensitivity (50.0%) and negative predictive value (96.7%) of equilibrium phase CT were the lowest among the three phases of CT scans. CONCLUSION: The portal venous phase CT was the most accurate scan to detect pancreatic duct injuries. However, equilibrium phase CT might underestimate major pancreatic injuries. Multiphasic CT shows early promise in this clinical application and further multi-institutional studies to verify its accuracy and reveal the optimal CT methodology are needed.
KW - Blunt abdominal injuries
KW - Multidetector CT
KW - Multiphasic CT
KW - Pancreatic duct injuries
UR - http://www.scopus.com/inward/record.url?scp=40549094940&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=40549094940&partnerID=8YFLogxK
U2 - 10.1097/TA.0b013e31802c5ba0
DO - 10.1097/TA.0b013e31802c5ba0
M3 - Article
VL - 64
SP - 666
EP - 672
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 3
ER -