Clinical Value of CT for Differentiation between Ascites and Hemorrhage: An Experimental In-Vitro Study

Kerschbaum, Maximilian; Schurr, Leonhard Andreas; Riedl, Moritz; Mayr, Agnes; Weiss, Iris R.; Klute, Lisa; Popp, Daniel; Pfeifer, Christian; Ernstberger, Antonio; Alt, Volker; Dendl, Lena Marie

doi:10.3390/jcm10010076

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…In cases where FF and HP were not explicitly differentiated in the radiology report, the fluid density was measured by the reviewer and determined to be HP if >20 HU while FF was considered anything <20 HU. 10,11 In cases where one or more of these findings were present, additional demographic and clinical data was collected. The presence of solid organ injury was also recorded.…”

Section: Methodsmentioning

confidence: 99%

Identifying Radiographic and Clinical Indicators to Reduce the Occurrence of Nontherapeutic Laparotomy for Blunt Bowel and Mesenteric Injury

Blackley

Smith

Lee

et al. 2023

The American Surgeon™

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Background Roughly 5% of patients with blunt abdominal trauma (BAT) have a blunt bowel and/or mesenteric injury (BBMI). Determining the need for operative management in these patients can be challenging when hemodynamically stable. Single center studies have proposed scoring systems based on CT findings to guide management. Our study aimed to determine the predictability of abdominopelvic CT scan (CT A/P) findings in conjunction with clinical exam to determine the necessity of operative intervention for BBMI. Methods Patients presenting from 2017 to 2022 to the University of South Alabama Level 1 Trauma Center after motor vehicle collision were retrospectively reviewed. Patients with CT findings suggestive of BBMI were further analyzed, noting CT findings, Glasgow coma scale (GCS), shock index, abdominal exam, operative or nonoperative management, and intraoperative intervention. Results 1098 patients with BAT underwent CT A/P. 139 patients had ≥1 finding suggestive of BBMI. 38 patients underwent surgical exploration and 30 had surgically confirmed BBMI. 27 patients required intervention for BBMI. Univariate analysis indicated that pneumoperitoneum ( p < 0.0001), active extravasation of contrast ( p = 0.0001), hemoperitoneum without solid organ injury (SOI) ( p < 0.0001), peritonitis ( p < 0.0001), and mesenteric stranding( p < 0.05) were significantly associated with intervention. Conclusion In total, 30 patients had surgically confirmed BBMI. Active extravasation, pneumoperitoneum, hemoperitoneum without SOI, mesenteric stranding, and peritonitis were significant indicators of BBMI requiring intervention. CT and clinical findings cannot reliably predict the need for surgical intervention without ≥1 of these findings. Initial nonoperative management with serial clinical exams should be strongly considered to reduce incidence of nontherapeutic laparotomies.

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Section: Methodsmentioning

confidence: 99%

Identifying Radiographic and Clinical Indicators to Reduce the Occurrence of Nontherapeutic Laparotomy for Blunt Bowel and Mesenteric Injury

Blackley

Smith

Lee

et al. 2023

The American Surgeon™

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“…Hepatic ascites refers to ascites caused by liver function damage and portal hypertension due to cirrhosis. It is one of the most common complications of cirrhosis [ 1 – 3 ]. In the natural course of chronic liver disease, ascites is an important sign that cirrhosis progresses to decompensation of liver function [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Reconstruction Algorithm-Based CT Imaging for the Diagnosis of Hepatic Ascites

Zhang

Diao

et al. 2022

Computational and Mathematical Methods in Medicine

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The study was aimed at exploring the diagnostic value of artificial intelligence reconstruction algorithm combined with CT image parameters on hepatic ascites, expected to provide a reference for the etiological evaluation of clinical abdominal effusion. Specifically, the adaptive iterative hard threshold (AIHT) algorithm for CT image reconstruction was proposed. Then, 100 patients with peritoneal effusion were selected as the research subjects. After 8 cases were excluded, the remaining was divided into 50 cases of the S1 group (hepatic ascites) and 42 cases of the D0 group (cancerous peritoneal effusion). Gemstone energy spectrum CT scanning was performed on all patients, and CT image parameters of the two groups were compared. It was found that CT value of mixed energy, CT value of 60-100 KeV single energy, concentration value of water (calcium), concentration value of water (iodine), and slope of energy spectrum curve in the S1 group were significantly lower than those in the D0 group ( P < 0.05 ). The effective atomic number in the S1 group was significantly higher than that in the D0 group ( P < 0.05 ). Of the 50 patients in the S1 group, 3 (6%) had an ascending and 47 (94%) had a descending spectral curve. Of the 42 patients in the D0 group, 37 (88.1%) had an ascending and 5 (11.9%) had a descending spectral curve. The sensitivity and specificity of water (iodine) were 0.927 and 0.836, respectively. The sensitivity and specificity of water (calcium) were 0.863 and 0.887, respectively. For different scan ranges ([0,90]; [0,120]), root mean square error (RMSE) of AIHT reconstructed image was significantly smaller than that of traditional algorithm, while peak signal-to-noise ratio (PSNR) was opposite. The differences were statistically significant ( P < 0.05 ). In conclusion, AIHT-based CT images can better display the distribution of hepatic ascites, and the parameters of CT value, effective atomic number, water (iodine), water (calcium), and spectral curve can all provide help for the identification of hepatic ascites. Especially, water (iodine) and water (calcium) demonstrated high diagnostic performance of hepatic ascites.

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Post-operative complications of cholecystectomy: what the radiologist needs to know

Kazi,

Siddiqui,

Thimmappa

et al. 2024

Abdom Radiol

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Cholecystectomy is one of the most performed surgical procedures. The safety of this surgery notwithstanding, the sheer volume of operations results in a notable incidence of post-cholecystectomy complications. Early and accurate diagnosis of such complications is essential for timely and effective management. Imaging techniques are critical for this purpose, aiding in distinguishing between expected postsurgical changes and true complications. This review highlights current knowledge on the indications for cholecystectomy, pertinent surgical anatomy and surgical technique, and the recognition of anatomical variants that may complicate surgery. The article also outlines the roles of various imaging modalities in identifying complications, the spectrum of possible postsurgical anatomical changes, and the implications of such findings. Furthermore, we explore the array of complications that can arise post-cholecystectomy, such as biliary system injuries, gallstone-related issues, vascular complications, and the formation of postsurgical collections. Radiologists should be adept at identifying normal and abnormal postoperative findings to guide patient management effectively. Graphical abstract

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Clinical Value of CT for Differentiation between Ascites and Hemorrhage: An Experimental In-Vitro Study

Cited by 4 publications

References 8 publications

Identifying Radiographic and Clinical Indicators to Reduce the Occurrence of Nontherapeutic Laparotomy for Blunt Bowel and Mesenteric Injury

Identifying Radiographic and Clinical Indicators to Reduce the Occurrence of Nontherapeutic Laparotomy for Blunt Bowel and Mesenteric Injury

Reconstruction Algorithm-Based CT Imaging for the Diagnosis of Hepatic Ascites

Post-operative complications of cholecystectomy: what the radiologist needs to know

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