Basak Sandip, Nazarian Levon N, Wechsler Richard J, Parker Laurence, Williams Brian D, Lev-Toaff Anna S, Kurtz Alfred B
Department of Radiology, Thomas Jefferson University Hospital, 111 South 11th Street, Philadelphia, PA 19107, USA.
Clin Imaging. 2002 Nov-Dec;26(6):405-7. doi: 10.1016/s0899-7071(02)00535-1.
To determine whether intravenous contrast improves the ability of radiologists to establish the cause of acute abdominal pain after nondiagnostic or normal unenhanced CT.
Out of 164 consecutive emergency department patients presenting with less than 48 h of nontraumatic, acute abdominal pain, a confident diagnosis for cause of pain was made prospectively in 71/164 (43%) patients on these unenhanced scans by the monitoring radiologist. In the other 93 patients, our study sample, intravenous contrast-enhanced CT was obtained. At a later date, retrospectively, two experienced abdominal CT radiologists independently evaluated unenhanced CT scans alone for potential causes of pain and diagnostic confidence level on a 1-3 scale. At least 2 weeks later, intravenous enhanced and unenhanced scans were read side-by-side for the same assessment.
There was no significant difference in diagnostic confidence levels comparing unenhanced CT alone (2.59) vs. intravenous enhanced and unenhanced CT together (2.64). Chi-square analysis found no significant difference in finding a cause for pain when intravenous contrast was added compared to the initial unenhanced scan alone.
Intravenous contrast did not significantly improve the ability of CT to establish a cause of abdominal pain after a negative or nondiagnostic unenhanced CT.
确定静脉注射造影剂是否能提高放射科医生在非诊断性或正常平扫CT后确定急性腹痛病因的能力。
在164例连续就诊的急诊科患者中，这些患者出现非创伤性急性腹痛的时间少于48小时，负责监测的放射科医生通过这些平扫CT前瞻性地对71/164（43%）例患者的疼痛病因做出了明确诊断。在另外93例患者（我们的研究样本）中，进行了静脉注射造影剂增强CT检查。之后，两名经验丰富的腹部CT放射科医生回顾性地独立评估仅平扫CT扫描，以确定疼痛的潜在原因，并在1-3级量表上评估诊断置信度。至少2周后，对静脉增强扫描和平扫扫描进行并排阅读以进行相同的评估。
比较单纯平扫CT（2.59）与静脉增强和平扫CT联合（2.64）时，诊断置信度没有显著差异。卡方分析发现，与单纯初始平扫CT相比，添加静脉造影剂后在找出疼痛原因方面没有显著差异。
静脉注射造影剂并不能显著提高CT在平扫CT为阴性或非诊断性结果后确定腹痛病因的能力。
