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Comparison of diagnostic performance between single- and multiphasic contrast-enhanced abdominopelvic computed tomography in patients admitted to the emergency department with abdominal pain: potential radiation dose reduction

 Shin Hye Hwang  ;  Je Sung You  ;  Mi Kyong Song  ;  Jin-Young Choi  ;  Myeong-Jin Kim  ;  Yong Eun Chung 
 EUROPEAN RADIOLOGY, Vol.25(4) : 1048-1058, 2015 
Journal Title
Issue Date
Abdominal Pain/diagnostic imaging* ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Contrast Media* ; Emergency Service, Hospital* ; Female ; Humans ; Male ; Middle Aged ; Multidetector Computed Tomography/methods* ; Pelvis/diagnostic imaging* ; Radiation Dosage ; Radiographic Image Enhancement/methods* ; Young Adult
Abdominopelvic computed tomography ; Emergency radiology ; Radiation dose reduction ; Dynamic computed tomography
OBJECTIVES: To evaluate feasibility of radiation dose reduction by optimal phase selection of computed tomography (CT) in patients who visited the emergency department (ED) for abdominal pain. METHODS: We included 253 patients who visited the ED for abdominal pain. They underwent multiphasic CT including precontrast, late arterial phase (LAP), and hepatic venous phase (HVP). Three image sets (HVP, precontrast + HVP, and precontrast + LAP + HVP) were reviewed. Two reviewers determined the most appropriate diagnosis with five-point confidence scale. Diagnostic performances were compared among image sets by weighted-least-squares method or DeLong's method. Linear mixed model was used to assess changes of diagnostic confidence and radiation dose. RESULTS: There was no difference in diagnostic performance among three image sets, although diagnostic confidence level was significantly improved after review of triphasic images compared with both HVP images only or HVP with precontrast images (confidence scale, 4.64 ± 0.05, 4.66 ± 0.05, and 4.76 ± 0.04 in the order of the sets; overall P = 0.0008). Similar trends were observed in the subgroup analysis for diagnosis of pelvic inflammatory disease and cholecystitis. CONCLUSIONS: There is no difference between HVP-CT alone and multiphasic CT for the diagnosis of causes of abdominal pain in patients admitted to the ED without prior chronic disease or neoplasia. KEY POINTS: • There was no difference in diagnostic performance of HVP CT and multiphasic CT. • The diagnostic confidence level was improved after review of the LAP images. • HVP CT can achieve diagnostic performance similar to that of multiphasic CT, while minimizing radiation.
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1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Song, Mi Kyung(송미경)
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Chung, Yong Eun(정용은) ORCID logo https://orcid.org/0000-0003-0811-9578
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
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