Norton L, Eule J, Burdick D
Surgery. 1978 Sep;84(3):370-8.
Three new diagnostic techniques, gray-scale ultrasonography, gallium-67 scanning (67Ga), and computed tomography (CT) were used in combination to detect intraperitoneal abscess in 30 patients. All 30 had sonography, 24 were scanned for 67Ga, and 15 underwent CT. Nine had three tests and 21 had two. Accuracy of results was evaluated by subsequent laparotomy in 16 and by clinical impression in the remainder. Ultrasound was accurate (true positive and true negative) in 12 of 16 (75%) operated patients, with 12% false-positive and 12% false-negative results. Gallium correctly diagnosed nine of 14 (64%) operated patients having 22% false-positive and 14% false-negative diagnoses. CT was accurate in five of seven (71%) patients evaluated by operation, with 14% false positives and 14% false negatives. Overall accuracies for both operated and clinical groups was ultrasound 57%, gallium 54%, and CT 67%, not significantly different results. Three tests agreed in only two of nine patients (22%), with no single test more accurate than another. Two tests agreed in 57%, with no test superior to another. It is concluded that ultrasonography, 67Ga scanning, and CT each have significant limits in diagnosing intra-abdominal pus. No single test is better than another. Disagreement among test results in the same patient obviates use of more than one technique in most instances.
三种新的诊断技术，即灰阶超声检查、镓-67扫描（67Ga）和计算机断层扫描（CT）联合用于检测30例患者的腹腔脓肿。30例患者均接受了超声检查，24例进行了67Ga扫描，15例接受了CT检查。9例患者接受了三项检查，21例接受了两项检查。16例患者通过后续剖腹手术评估结果准确性，其余患者通过临床印象评估。在16例接受手术的患者中，超声检查准确（真阳性和真阴性）的有12例（75%），假阳性结果为12%，假阴性结果为12%。镓扫描在14例接受手术的患者中正确诊断出9例（64%），假阳性诊断为22%，假阴性诊断为14%。通过手术评估的7例患者中，CT在5例（71%）患者中诊断准确，假阳性为14%，假阴性为14%。手术组和临床组的总体准确率分别为：超声57%，镓54%，CT 67%，结果无显著差异。三项检查仅在9例患者中的2例（22%）中结果一致，没有一项检查比另一项更准确。两项检查结果一致的占57%，没有一项检查优于另一项。结论是，超声检查、镓-67扫描和CT在诊断腹腔内脓液方面均有显著局限性。没有一项检查比另一项更好。同一患者检查结果不一致使得在大多数情况下无需使用多种技术。
