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European Radiology
Published in: European Radiology 4/2015

01-04-2015 | Computed Tomography

Comparison of diagnostic performance between single- and multiphasic contrast-enhanced abdominopelvic computed tomography in patients admitted to the emergency department with abdominal pain: potential radiation dose reduction

Authors: Shin Hye Hwang, Je Sung You, Mi Kyong Song, Jin-Young Choi, Myeong-Jin Kim, Yong Eun Chung

Published in: European Radiology | Issue 4/2015

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Abstract

Objectives

To evaluate feasibility of radiation dose reduction by optimal phase selection of computed tomography (CT) in patients who visited the emergency department (ED) for abdominal pain.

Methods

We included 253 patients who visited the ED for abdominal pain. They underwent multiphasic CT including precontrast, late arterial phase (LAP), and hepatic venous phase (HVP). Three image sets (HVP, precontrast + HVP, and precontrast + LAP + HVP) were reviewed. Two reviewers determined the most appropriate diagnosis with five-point confidence scale. Diagnostic performances were compared among image sets by weighted-least-squares method or DeLong’s method. Linear mixed model was used to assess changes of diagnostic confidence and radiation dose.

Results

There was no difference in diagnostic performance among three image sets, although diagnostic confidence level was significantly improved after review of triphasic images compared with both HVP images only or HVP with precontrast images (confidence scale, 4.64 ± 0.05, 4.66 ± 0.05, and 4.76 ± 0.04 in the order of the sets; overall P = 0.0008). Similar trends were observed in the subgroup analysis for diagnosis of pelvic inflammatory disease and cholecystitis.

Conclusions

There is no difference between HVP-CT alone and multiphasic CT for the diagnosis of causes of abdominal pain in patients admitted to the ED without prior chronic disease or neoplasia.

Key Points

• There was no difference in diagnostic performance of HVP CT and multiphasic CT.
• The diagnostic confidence level was improved after review of the LAP images.
• HVP CT can achieve diagnostic performance similar to that of multiphasic CT, while minimizing radiation.
Appendix
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Metadata
Title
Comparison of diagnostic performance between single- and multiphasic contrast-enhanced abdominopelvic computed tomography in patients admitted to the emergency department with abdominal pain: potential radiation dose reduction
Authors
Shin Hye Hwang
Je Sung You
Mi Kyong Song
Jin-Young Choi
Myeong-Jin Kim
Yong Eun Chung
Publication date
01-04-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 4/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3481-6

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