Department of Radiology, Emergency Center, Department of Forensic Medicine, and Division of Clinical Epidemiology, University Hospital of Geneva, 4 rue Gabrielle Perret-Gentil, 1211 Geneva 14, Switzerland.
Radiology. 2012 Dec;265(3):772-9. doi: 10.1148/radiol.12112767. Epub 2012 Sep 5.
To evaluate the diagnostic performance of abdominal radiography in the detection of illegal intracorporeal containers (hereafter, packets), with low-dose computed tomography (CT) as the reference standard.
This study was approved by the institutional ethical review board, with written informed consent. From July 2007 to July 2010, 330 people (296 men, 34 women; mean age, 32 years [range, 18-55 years]) suspected of having ingested drug packets underwent supine abdominal radiography and low-dose CT. The presence or absence of packets at abdominal radiography was reported, with low-dose CT as the reference standard. The density and number of packets (≤ 12 or >12) at low-dose CT were recorded and analyzed to determine whether those variables influence interpretation of results at abdominal radiography.
Packets were detected at low-dose CT in 53 (16%) suspects. Sensitivity of abdominal radiography for depiction of packets was 0.77 (41 of 53), and specificity was 0.96 (267 of 277). The packets appeared isoattenuated to the bowel contents at low-dose CT in 16 (30%) of the 53 suspects with positive results. Nineteen (36%) of the 53 suspects with positive low-dose CT results had fewer than 12 packets. Packets that were isoattenuated at low-dose CT and a low number of packets (≤12) were both significantly associated with false-negative results at abdominal radiography (P = .004 and P = .016, respectively).
Abdominal radiography is mainly limited by low sensitivity when compared with low-dose CT in the screening of people suspected of carrying drug packets. Low-dose CT is an effective imaging alternative to abdominal radiography.
以低剂量 CT 为参照标准，评估腹部 X 线摄影在检测非法体内容器（以下简称包裹）中的诊断性能。
本研究经机构伦理审查委员会批准，并获得书面知情同意。2007 年 7 月至 2010 年 7 月，330 例（296 例男性，34 例女性；平均年龄 32 岁[范围 18-55 岁]）疑似吞食药物包裹的患者接受仰卧位腹部 X 线摄影和低剂量 CT 检查。以低剂量 CT 为参照标准，报告腹部 X 线摄影是否存在包裹。记录并分析低剂量 CT 上包裹的密度和数量（≤12 个或>12 个），以确定这些变量是否影响腹部 X 线摄影的结果解读。
在 53 例（16%）疑似患者中，低剂量 CT 检测到包裹。腹部 X 线摄影显示包裹的敏感度为 0.77（53 例中的 41 例），特异度为 0.96（277 例中的 267 例）。在 53 例阳性结果的患者中，16 例（30%）低剂量 CT 显示包裹与肠内容物等密度。53 例阳性低剂量 CT 结果的患者中，19 例（36%）的包裹数量少于 12 个。低剂量 CT 等密度且包裹数量较少（≤12 个）与腹部 X 线摄影的假阴性结果显著相关（P =.004 和 P =.016）。
与低剂量 CT 相比，腹部 X 线摄影在筛选携带药物包裹的疑似人群时主要受到低敏感度的限制。低剂量 CT 是腹部 X 线摄影的有效替代成像方法。
