Yon-Cheong Wong1, Li-Jen Wang2, Cheng-Hsien Wu2, Huan-Wu Chen2, Being-Chuan Lin3, Yu-Pao Hsu3. 1. Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Gueishan, Taoyuan, 33333, Taiwan. ycwong@cgmh.org.tw. 2. Emergency and Critical Care Radiology, Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University, 5 Fu-Hsing Street, Gueishan, Taoyuan, 33333, Taiwan. 3. Division of Trauma and Emergency Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University, Gueishan, Taoyuan, Taiwan.
Abstract
PURPOSE: To investigate whether peritoneal fluid of low CT Hounsfield units is an important screening criterion for traumatic bowel perforation. MATERIALS AND METHODS: We performed a retrospective study on two cohorts of blunt trauma patients who had peritoneal fluid. Intravenous and oral contrast was used for the first cohort (61 patients) as opposed to intravenous contrast only for the second cohort (60 patients). We compared the CT Hounsfield units of peritoneal fluid with bowel perforation. The optimal cutoff value of CT Hounsfield units was determined, and its diagnostic values for bowel perforation were calculated. RESULTS: The mean CT Hounsfield units (HU) of peritoneal fluid with bowel perforation were significantly lower (30.3 ± 9.0 versus 44.1 ± 13.6 HU, p = 0.008) in the second cohort. The optimal cutoff value was 43 HU, and its sensitivity, specificity, accuracy and positive likelihood ratio were 100.0, 69.2, 73.3% and 3.3, respectively, for bowel perforation. Comparisons of CT HUs of peritoneal fluid with bowel perforation in the first cohort that used additional oral contrast for CT did not show statistically significant differences. CONCLUSION: Peritoneal fluid of low CT HU is a sensitive and important CT screening criterion for traumatic bowel perforation.
PURPOSE: To investigate whether peritoneal fluid of low CT Hounsfield units is an important screening criterion for traumatic bowel perforation. MATERIALS AND METHODS: We performed a retrospective study on two cohorts of blunt traumapatients who had peritoneal fluid. Intravenous and oral contrast was used for the first cohort (61 patients) as opposed to intravenous contrast only for the second cohort (60 patients). We compared the CT Hounsfield units of peritoneal fluid with bowel perforation. The optimal cutoff value of CT Hounsfield units was determined, and its diagnostic values for bowel perforation were calculated. RESULTS: The mean CT Hounsfield units (HU) of peritoneal fluid with bowel perforation were significantly lower (30.3 ± 9.0 versus 44.1 ± 13.6 HU, p = 0.008) in the second cohort. The optimal cutoff value was 43 HU, and its sensitivity, specificity, accuracy and positive likelihood ratio were 100.0, 69.2, 73.3% and 3.3, respectively, for bowel perforation. Comparisons of CT HUs of peritoneal fluid with bowel perforation in the first cohort that used additional oral contrast for CT did not show statistically significant differences. CONCLUSION: Peritoneal fluid of low CT HU is a sensitive and important CT screening criterion for traumatic bowel perforation.