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Diagnostic performance of CT esophagography in patients with suspected esophageal rupture / Álvaro Enrique Sanabria Quiroga  

Público ISBD Título : Diagnostic performance of CT esophagography in patients with suspected esophageal rupture Tipo de documento : documento electrónico Autores : Álvaro Enrique Sanabria Quiroga, Fecha de publicación : 2014 Títulos uniformes : Emergency Radiology Idioma : Inglés (eng) Palabras clave : Esophageal perforation  multidetector computed tomography  diagnosis  radiography  esophagogram Resumen : Esophageal rupture is a surgical catastrophe. The gold standard for diagnosing is iodine, water-soluble contrast medium esophagography. CT esophagography has shown promising results. This study aimed to assess the diagnostic performance of CT esophagography in patients with a suspicion of esophageal rupture. This prospective study assessed the performance of a diagnostic test and was approved by local IRB committee. Patients who presented with a clinical suspicion of esophageal rupture were included. CT esophagography findings were described by the emergency radiologist. Clinical outcomes (presence or absence of esophageal rupture) were reported by surgeons. The operative characteristics were calculated. A final predictive scale for rupture was built. A total of 64 patients were recruited (age 26.5 years, 90 % male, 82 % trauma). Sensitivity, specificity, and positive and negative likelihood ratios (LRs) were 77.7 % (95 % confidence interval (CI) 45–100), 94.3 % (87.2–100), 14 (9.81–19.9), and 0.24 (0.05–1.22), respectively. The final model for predicting rupture included five variables: age (odds ratio (OR) 1.03; 95 % CI, 0.95–1.11; p = 0.04), leakage of contrast media into the mediastinum or pleural space (OR 10.0; 95 % CI, 0.64–156.9; p = 0.10), extraluminal air or fluid collections (OR 43.1; 95 % CI, 1.52–1217.3; p = 0.027), esophageal wall thickening (OR 10.1; 95 % CI, 0.50–202.8; p = 0.12), and left pneumothorax or pleural effusion (OR 6.5; 95 % CI, 0.31–132.7; p = 0.2). The overall agreement was 0.40 (95 % CI, 0.09–0.72) for the predictive model. The model sensitivity was 50.0 %, and the specificity was 98.4 %. CT esophagography shows a good diagnostic performance in patients with a suspected esophageal rupture Mención de responsabilidad : Tatiana Suarez-Poveda, Carlos H Morales-Uribe, Alvaro Sanabria, Adriana Llano-Sánchez, Andrés Mauricio Valencia-Delgado, Luis Fernando Rivera-Velázquez, John Fernando Bedoya-Ospina Referencia : Emerg Radiol. 2014 Oct;21(5):505-10. DOI (Digital Object Identifier) : 10.1007/s10140-014-1222-4 PMID : 24748526 En línea : https://link.springer.com/article/10.1007%2Fs10140-014-1222-4 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3784 Diagnostic performance of CT esophagography in patients with suspected esophageal rupture [documento electrónico] / Álvaro Enrique Sanabria Quiroga,  . - 2014. Obra : Emergency Radiology Idioma : Inglés (eng) Palabras clave : Esophageal perforation  multidetector computed tomography  diagnosis  radiography  esophagogram Resumen : Esophageal rupture is a surgical catastrophe. The gold standard for diagnosing is iodine, water-soluble contrast medium esophagography. CT esophagography has shown promising results. This study aimed to assess the diagnostic performance of CT esophagography in patients with a suspicion of esophageal rupture. This prospective study assessed the performance of a diagnostic test and was approved by local IRB committee. Patients who presented with a clinical suspicion of esophageal rupture were included. CT esophagography findings were described by the emergency radiologist. Clinical outcomes (presence or absence of esophageal rupture) were reported by surgeons. The operative characteristics were calculated. A final predictive scale for rupture was built. A total of 64 patients were recruited (age 26.5 years, 90 % male, 82 % trauma). Sensitivity, specificity, and positive and negative likelihood ratios (LRs) were 77.7 % (95 % confidence interval (CI) 45–100), 94.3 % (87.2–100), 14 (9.81–19.9), and 0.24 (0.05–1.22), respectively. The final model for predicting rupture included five variables: age (odds ratio (OR) 1.03; 95 % CI, 0.95–1.11; p = 0.04), leakage of contrast media into the mediastinum or pleural space (OR 10.0; 95 % CI, 0.64–156.9; p = 0.10), extraluminal air or fluid collections (OR 43.1; 95 % CI, 1.52–1217.3; p = 0.027), esophageal wall thickening (OR 10.1; 95 % CI, 0.50–202.8; p = 0.12), and left pneumothorax or pleural effusion (OR 6.5; 95 % CI, 0.31–132.7; p = 0.2). The overall agreement was 0.40 (95 % CI, 0.09–0.72) for the predictive model. The model sensitivity was 50.0 %, and the specificity was 98.4 %. CT esophagography shows a good diagnostic performance in patients with a suspected esophageal rupture Mención de responsabilidad : Tatiana Suarez-Poveda, Carlos H Morales-Uribe, Alvaro Sanabria, Adriana Llano-Sánchez, Andrés Mauricio Valencia-Delgado, Luis Fernando Rivera-Velázquez, John Fernando Bedoya-Ospina Referencia : Emerg Radiol. 2014 Oct;21(5):505-10. DOI (Digital Object Identifier) : 10.1007/s10140-014-1222-4 PMID : 24748526 En línea : https://link.springer.com/article/10.1007%2Fs10140-014-1222-4 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3784

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