Penetrating Colorectal Injuries: Diagnostic Performance of Multidetector CT with Trajectography

David Dreizin; Alexis R Boscak; Michael J Anstadt; Nikki Tirada; William C Chiu; Felipe Munera; Uttam K Bodanapally; Michael Hornick; Deborah M Stein

doi:10.1148/radiol.2015152335

Back

Penetrating Colorectal Injuries: Diagnostic Performance of Multidetector CT with Trajectography

Journal article

Open access

Peer reviewed

Penetrating Colorectal Injuries: Diagnostic Performance of Multidetector CT with Trajectography

David Dreizin, Alexis R Boscak, Michael J Anstadt, Nikki Tirada, William C Chiu, Felipe Munera, Uttam K Bodanapally, Michael Hornick and Deborah M Stein

Radiology, Vol.281(3), pp.749-762

2016-12

DOI: https://doi.org/10.1148/radiol.2015152335

PMID: 27232639

Abstract

Multidetector Computed Tomography

Prospective Studies

Humans

Middle Aged

Male

Colon - injuries

Young Adult

Colon - diagnostic imaging

Wounds, Penetrating - diagnostic imaging

Rectum - diagnostic imaging

Adolescent

Adult

Female

Retrospective Studies

Rectum - injuries

Purpose To determine the diagnostic performance of multidetector computed tomography (CT) with trajectography for penetrating colorectal injuries. Materials and Methods This institutional review board-approved and HIPAA-compliant study was a 6-year blinded retrospective review by two independent readers of 182 consecutive patients who preoperatively underwent 40- or 64-row multidetector CT for penetrating torso trauma below the diaphragm and had surgically confirmed findings. Colorectal perforation was present in 42 patients. Trajectory analysis with postprocessing software was used for all studies. Additional signs evaluated were rectal contrast agent leak, collections of extruded fecal material, mural defect, wall thickening, abnormal enhancement, free fluid or stranding, and free air. The quality of the colorectal contrast agent administration was recorded. Sensitivity, specificity, predictive values, areas under the receiver operating characteristic curves (AUCs), and Cohen κ were determined. Results In patients with rectal contrast agent administration (n = 151), AUCs were 0.90-0.91, which indicated excellent accuracy. Trajectory was sensitive (88%-91%). For single wounds (n = 104), sensitivity of trajectory was 96% for both readers, but was only 80% for multiple wounds (n = 47). Contrast agent leak was highly specific (96%-98%), but insensitive (42%-46%). Improved diagnostic performance was observed in patients with poor colonic distension or opacification. Accuracy remained high (AUC, 0.86-0.99) in the group without rectal contrast agent administration (n = 31). Conclusion Trajectory had excellent sensitivity, while rectal contrast agent leak was specific but insensitive. Sensitivity of trajectory was lower for multiple wounds. Accuracy remained high in patients without rectal contrast agent administration. RSNA, 2016.

Files and links (1)

url

https://doi.org/10.1148/radiol.2015152335View

Published (Version of record) Open

Metrics

11 Record Views

14 Times Cited - Web of Science

See more details

InCites Highlights

These are selected metrics from InCites Benchmarking & Analytics tool, related to this output

Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.216 Abdominal Surgery; 1.216.1080 Blunt Abdominal Trauma
Web Of Science research areas: Radiology, Nuclear Medicine & Medical Imaging
ESI research areas: Clinical Medicine

UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

Source: InCites

Details

Title: Penetrating Colorectal Injuries: Diagnostic Performance of Multidetector CT with Trajectography
Creators: David Dreizin - From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., A.R.B., U.K.B., M.H.) and Department of Surgery (M.J.A., W.C.C., D.M.S.), University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, Brigham and Women's Hospital, Brookline, Mass (N.T.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine, Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
Alexis R Boscak - From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., A.R.B., U.K.B., M.H.) and Department of Surgery (M.J.A., W.C.C., D.M.S.), University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, Brigham and Women's Hospital, Brookline, Mass (N.T.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine, Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
Michael J Anstadt - From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., A.R.B., U.K.B., M.H.) and Department of Surgery (M.J.A., W.C.C., D.M.S.), University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, Brigham and Women's Hospital, Brookline, Mass (N.T.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine, Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
Nikki Tirada - From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., A.R.B., U.K.B., M.H.) and Department of Surgery (M.J.A., W.C.C., D.M.S.), University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, Brigham and Women's Hospital, Brookline, Mass (N.T.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine, Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
William C Chiu - From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., A.R.B., U.K.B., M.H.) and Department of Surgery (M.J.A., W.C.C., D.M.S.), University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, Brigham and Women's Hospital, Brookline, Mass (N.T.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine, Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
Felipe Munera - From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., A.R.B., U.K.B., M.H.) and Department of Surgery (M.J.A., W.C.C., D.M.S.), University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, Brigham and Women's Hospital, Brookline, Mass (N.T.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine, Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
Uttam K Bodanapally - From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., A.R.B., U.K.B., M.H.) and Department of Surgery (M.J.A., W.C.C., D.M.S.), University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, Brigham and Women's Hospital, Brookline, Mass (N.T.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine, Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
Michael Hornick - From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., A.R.B., U.K.B., M.H.) and Department of Surgery (M.J.A., W.C.C., D.M.S.), University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, Brigham and Women's Hospital, Brookline, Mass (N.T.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine, Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
Deborah M Stein - From the Department of Diagnostic Radiology and Nuclear Medicine (D.D., A.R.B., U.K.B., M.H.) and Department of Surgery (M.J.A., W.C.C., D.M.S.), University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, 22 S Greene St, Baltimore, MD 21201; Department of Radiology, Brigham and Women's Hospital, Brookline, Mass (N.T.); and Department of Diagnostic Radiology, University of Miami Leonard Miller School of Medicine, Jackson Memorial Hospital & Ryder Trauma Center, Miami, Fla (F.M.)
Publication Details: Radiology, Vol.281(3), pp.749-762
Publisher: United States
Academic Unit: Miller School of Medicine; UMMG Department of Radiology
Language: English
Resource Type: Journal article
PMID: 27232639
Record Identifier: 991031577033102976