Relative accuracy of emergency CT in adults with non-traumatic abdominal pain

Perry, Helen; Foley, Kieran; Witherspoon, J. Thornwell; Powell-Chandler, Anna; Abdelrahman, Tarig; Roberts, Ashley; Lewis, Wyn G.

doi:10.1259/bjr.20150416

Cited by 9 publications

(2 citation statements)

References 19 publications

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“…The initial report changed in 5% of all reanalysed reports. Peery et al [16] showed similar findings in CT examinations made because abdominal pain. In their study, the reports made in normal working hours had higher strength of agreement than CTs reported out of hours but there was no significant difference in overall accuracy, and reporter seniority was not associated with improved diagnostic accuracy.…”

Section: Discussionmentioning

confidence: 66%

Is reassessment of Computed Tomography Reports Worthwhile in Acute Diverticulitis?

Mäntymäki,

Grönroos,

Aronen

et al. 2024

Dig Surg

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Introduction Since the assessment of the disease severity in acute diverticulitis (AD) is of utmost importance to determine the optimal treatment and the need for follow-up investigations, we wanted to investigate whether the first CT report is compatible with daytime reassessment report and whether the value of initial report changes according to the experience of the radiologist. Methods Consecutive patients from tertiary referral center with AD were included. CT images done in the emergency department were initially analysed by either resident radiologists or consultant radiologists and then later reanalysed by consultant abdominal radiologists. Discrepancies between reports were noted. Results Of total of 562 patients with AD, CT images were reanalysed in 439 cases. In 22 reports (5.0%) the final report was significantly different from the initial report and management changed in 20 cases. In reports of uncomplicated acute diverticulitis (UAD) reanalysis changed initial assessment in 4.0% of the cases and in complicated acute diverticulitis (CAD) in 9.1%. When consultant and resident radiologists were compared, there was no significant difference. Conclusion Although no statistical difference could be noted between residents and consultants, the final report was significantly different in overall 5% of the cases when reanalysed at normal working hours by an experienced consultant abdominal radiologist. Therefore, we conclude that reassessment of CT reports is worthwhile in AD.

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Section: Discussionmentioning

confidence: 66%

Is reassessment of Computed Tomography Reports Worthwhile in Acute Diverticulitis?

Mäntymäki,

Grönroos,

Aronen

et al. 2024

Dig Surg

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“…CT is useful in the evaluation of patients with a nonspecific clinical presentation or broad differential diagnosis, including gynecologic and nongynecologic etiologies, and may be a first-line imaging modality in this setting. CT with intravenous (IV) contrast had higher sensitivity than ultrasound (US) (89% versus 70%) for urgent diagnoses in a mixed-gender group of adults with abdominopelvic pain [5], and approximately 88% overall accuracy compared with surgical diagnosis in a similar cohort [6]. Although specific data are lacking for the postmenopausal population, CT is also widely used as a second-line imaging modality in patients with an equivocal or nondiagnostic US evaluation, particularly when there is concern for appendicitis [7,8].…”

Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

ACR Appropriateness Criteria® Postmenopausal Acute Pelvic Pain

Gyn¹,

Imaging

Henrichsen

et al. 2021

Journal of the American College of Radiology

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Acute pelvic pain is a common presenting complaint in both the emergency room and outpatient settings. Pelvic pain of gynecologic origin in postmenopausal women occurs less frequently than in premenopausal women; however, it has important differences in etiology. The most common causes of postmenopausal pelvic pain from gynecologic origin are ovarian cysts, uterine fibroids, pelvic inflammatory disease, and ovarian neoplasm. Other etiologies of pelvic pain are attributable to urinary, gastrointestinal, and vascular systems. As the optimal imaging modality varies for these etiologies, it is important to narrow the differential diagnosis before choosing the initial diagnostic imaging examination. Transabdominal and transvaginal ultrasound are the best initial imaging techniques when the differential is primarily of gynecologic origin. CT with intravenous (IV) contrast is more useful if the differential diagnosis remains broad. MRI without IV contrast or MRI without and with IV contrast, as well as CT without IV contrast may also be used for certain differential considerations.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

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