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Open Access 20-02-2024 | Computed Tomography | Original Article

Abdominal computed tomography scoring systems and experienced radiologists in the radiological diagnosis of small bowel and mesenteric injury

Authors: Devin M. O’Toole, Nicole V. Warrington, Nicholas G Matthees, Kristina M. Kupanoff, James N. Bogert, Michael D. Jones, Hahn Soe-Lin, Dih-Dih Huang, Jordan A. Weinberg

Published in: Emergency Radiology | Issue 2/2024

Abstract

Purpose

Blunt bowel and/or mesenteric injury requiring surgery presents a diagnostic challenge. Although computed tomography (CT) imaging is standard following blunt trauma, findings can be nonspecific. Most studies have focused on the diagnostic value of CT findings in identifying significant bowel and/or mesenteric injury (sBMI). Some studies have described scoring systems to assist with diagnosis. Little attention, has been given to radiologist interpretation of CT scans. This study compared the discriminative ability of scoring systems (BIPS and RAPTOR) with radiologist interpretation in identifying sBMI.

Methods

We conducted a retrospective chart review of trauma patients with suspected sBMI. CT images were reviewed in a blinded fashion to calculate BIPS and RAPTOR scores. Sensitivity and specificity were compared between BIPS, RAPTOR, and the admission CT report with respect to identifying sBMI.

Results

One hundred sixty-two patients were identified, 72 (44%) underwent laparotomy and 43 (26.5%) had sBMI. Sensitivity and specificity were: BIPS 49% and 87%, AUC 0.75 (0.67–0.81), P < 0.001; RAPTOR 46% and 82%, AUC 0.72 (0.64–0.79), P < 0.001; radiologist impression 81% and 71%, AUC 0.82(0.75–0.87), P < 0.001. The discriminative ability of the radiologist impression was higher than RAPTOR (P = 0.04) but not BIPS (P = 0.13). There was not a difference between RAPTOR vs. BIPS (P = 0.55).

Conclusion

Radiologist interpretation of the admission CT scan was discriminative of sBMI. Although surgical vigilance, including evaluation of the CT images and patient, remains fundamental to early diagnosis, the radiologist’s impression of the CT scan can be used in clinical practice to simplify the approach to patients with abdominal trauma.

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Title: Abdominal computed tomography scoring systems and experienced radiologists in the radiological diagnosis of small bowel and mesenteric injury
Authors: Devin M. O’Toole
Nicole V. Warrington
Nicholas G Matthees
Kristina M. Kupanoff
James N. Bogert
Michael D. Jones
Hahn Soe-Lin
Dih-Dih Huang
Jordan A. Weinberg
Publication date: 20-02-2024
Publisher: Springer International Publishing
Keywords: Computed Tomography
Computed Tomography
Laparotomy
Laparotomy
Published in: Emergency Radiology / Issue 2/2024
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI: https://doi.org/10.1007/s10140-023-02197-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abdominal computed tomography scoring systems and experienced radiologists in the radiological diagnosis of small bowel and mesenteric injury

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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